CN109152583A

CN109152583A - System and method for thrombus and transmission medicament

Info

Publication number: CN109152583A
Application number: CN201780029881.1A
Authority: CN
Inventors: 布拉德利·S·卡伯特; 大卫·M·卢克; 马克·马拉比
Original assignee: Walker Vascular Ltd
Current assignee: Walker Vascular Ltd; Walk Vascular LLC
Priority date: 2016-04-06
Filing date: 2017-04-06
Publication date: 2019-01-04
Anticipated expiration: 2037-04-06
Also published as: EP4144310A1; US20200155178A1; CN113768583A; CA3019166A1; JP2019513452A; EP3439561B1; US10492805B2; US20220378446A1; US20220378448A1; US20220378445A1; US11510689B2; US20220378460A1; US20170290598A1; EP3439561A1; US20220378447A1; CN109152583B; JP7221692B2; WO2017177022A1; JP2023022249A; EP3439561A4

Abstract

A kind of system for sucking thrombus and transmitting medicament comprising: suction lead has supply chamber and suction chamber, and supply chamber has proximal end, distal end and wall, and suction chamber has proximal end, open distal end and the inner wall surface adjacent with open distal end；And at least one aperture, its far-end for being located at supply chamber is adjacent with the supply distal end of chamber, at least one aperture is fluidly connected to suction chamber and is positioned adjacent to the open distal end of suction chamber, wherein, at least one aperture is configured to generate spray pattern, the spray pattern impacts in the inner wall surface of suction chamber, so that spray pattern makes spray pattern be transformed into the stream at least substantially distad oriented that can leave the open distal end of suction chamber when impact is in inner wall surface.

Description

System and method for thrombus and transmission medicament

Technical field

The disclosure relates generally to medical device and its application methods.It is cut more particularly it relates to suck with thrombus Except (aspiration and thrombectomy) device and its application method.

Background technique

A variety of device and system are had existed to help to remove thrombotic substance.These include: will using vacuum syringe Thrombus is drawn into the simple suction line types of devices in syringe；Simple flushing and suction apparatus；With using mechanical spiral shell Rotation silk bores the more complicated device far from distal end sucking, the rotary part for being macerated and conveying thrombotic substance；Use extra-high voltage To be macerated thrombus and generate venturi effect so that the system that material washes away will be macerated.

All devices as described above have limitation due to respective design characteristics.For example, simple suction lead Ease for use is provided and is unfolded rapidly, but can become to be blocked or with other when facing old man, more organized thrombotic substance Mode becomes unable to operate.This device must be removed and be cleaned outside body, then be re-inserted into vascular In system, this increases the time required for surgical procedure, and increases the chance for making catheter shaft twist together.This knot can lead to It crosses the cross-sectional area for reducing conduit and reduces performance, or may make device that cannot operate.

Mechanical rotary device is grabbed using auger and carries thrombus far from target area.Some devices are via Dewar bottle Conveying capacity is generated, and other devices generate pressure difference in the case where auger is used as low-lift pump at the distal end of device.This A little devices usually work slowly, and when should be further advanced to the middle aspect of lesion (lesion) not for device Feedback is provided to doctor.

The device of type of flush includes the device of manual flushing type, and in this device, doctor manipulates the pump of hand-drive To provide flowing salt water in the end of device, to be crushed and suck thrombus substance, this is potentially based on doctor in surgical procedure Period consistently pumps the ability of the device and introduces performance change.Flusher further includes high-pressure flushing device, is macerated blood The thrombotic substance of emulsification is transported to collecting bag by the vortex that high-pressure fluid generates by bolt, then utilization.These devices are moving It is effective but excessive by the pressure that device generates in terms of except the gradational thrombotic substance of institute so that it is directed to given blood vessel Effect may interrupt muscle stimulation mechanism and in certain patients generate bradycardia (bradycardia, areocardia) Event sometimes requires that and before the use places pacing lead in patients.In addition, outside conduit with thrombotic substance Interaction may allow bulk materials to flee from capture mechanism.

Summary of the invention

In an embodiment of the disclosure, it is a kind of for suck thrombus and transmit medicament system include: that sucking is led Pipe, has a supply chamber and suction chamber, and supply chamber has proximal end, distal end and a wall, suction chamber have proximal end, open distal end and with it is spacious The adjacent inner wall surface in the distal end opened；And at least one aperture, the distal end phase positioned at the far-end of supply chamber or with supply chamber Neighbour, at least one aperture are fluidly connected to suction chamber, at least one aperture is positioned adjacent to the open distal end of suction chamber, In, at least one aperture is configured to generate spray pattern when pressurized fluid is pumped through supply chamber, so that when sucking is led Make spray pattern impact in the inner wall surface of suction chamber when the distal end of pipe is dipped into aqueous environment, and makes spray pattern It is transformed into when in inner wall surface at least substantially distad orienting for the open distal end that can leave suction chamber in impact Stream.

In the another embodiment of the disclosure, a kind of method for transmitting medicament include: provide have proximal end and The suction lead of distal end, and suction lead includes supply chamber, suction chamber and at least one aperture, supply chamber have proximal end, remote End and wall, suction chamber have proximal end, open distal end and the inner wall surface adjacent with open distal end, at least one aperture is located at The far-end or adjacent with the supply distal end of chamber of chamber is supplied, at least one aperture is fluidly connected to suction chamber, at least one hole Mouth is positioned adjacent to the open distal end of suction chamber, wherein at least one aperture is configured to be pumped through when pressurized fluid Spray pattern is generated when supplying chamber: the distal end of suction lead being inserted into blood vessel, so that the open distal end of suction chamber and thrombus It is adjacent；And by supply chamber injection medicament, so that the spray pattern of medicament generally flows out at least one in a first direction Aperture and inner wall surface against suction chamber, thus after the spray pattern of medicament reaches the inner wall surface of suction chamber, medicament Most of spray pattern open end of distally out suction chamber and adjacent with thrombus in a second direction, wherein second party To different from first direction.

In the another embodiment of the disclosure, one kind includes: for making thrombectomby surgical procedure visualization method The suction lead with supply chamber and suction chamber is provided, supply chamber has distal end and wall, and suction chamber has open distal end and interior Wall surface, and suction lead has an aperture, the aperture is adjacent with the distal end of chamber is supplied and internal flow with suction chamber Connection, which is positioned adjacent to the open distal end of suction chamber；The distal end of suction lead is inserted into blood vessel, so that suction chamber Open distal end it is adjacent with thrombus；Include the fluid of radiopaque contrast agent by supply chamber injection, while making radiography Or fluoroscopy image viewing；And the boundary of identification thrombus.

In the another embodiment of the disclosure, a kind of system for sucking thrombus includes: suction lead, has and supplies Chamber and suction chamber are answered, supply chamber has distal end and wall, and suction chamber has open distal end and inner wall surface；Aperture, with supply chamber Distal end it is adjacent, which is connected to the internal flow of suction chamber, which is positioned adjacent to the open distal end of suction chamber, Wherein, aperture is configured to generate spray pattern when pressurized fluid is pumped through supply chamber；And mandrel, have proximal end and It distally, distally include being bent and including being configured to the concave portion with the distal engagement of suction lead greater than 90 °, wherein Aperture can be translated by the tractive force being applied in mandrel in the transverse direction transverse to the longitudinal axis of suction lead.

In the another embodiment of the disclosure, a kind of system for sucking thrombus includes: suction lead, has supply Chamber and suction chamber, supply chamber have distal end and wall, and suction chamber has open distal end and inner wall surface；Aperture, with supply chamber Distally adjacent, which is connected to the internal flow of suction chamber, and aperture is positioned adjacent to the open distal end of suction chamber, In, aperture is configured to generate spray pattern when the fluid of pressurization is pumped through supply chamber, so that working as the remote of suction lead End is immersed spray pattern when in aqueous environment and is impacted in the inner wall surface of suction chamber；And fine filaments, have proximally and distally, Distal end includes enlarged, wherein fine filaments are configured to rotatable, and enlarged is enabled to destroy at least the one of thrombus Part.

In the another embodiment of the disclosure, a kind of system for removing encephalic blood or thrombus includes: probe, tool There are service duct and suction passage, suction passage has proximally and distally, and there is service duct distal end and wall, suction passage to have Opening and inner wall surface, opening are located at the far-end or adjacent with the distal end of suction passage of suction passage；Aperture, with service duct Distal end is adjacent and internal flow with suction passage be connected to, wherein aperture is configured to be pumped through when pressurized fluid Spray pattern is generated when service duct, so that spray pattern impact is in the inner wall surface of suction passage；And Vltrasonic device, position In the opening of suction passage or with being open it is adjacent, and Vltrasonic device is configured between about 1kHz to about 20MHz Frequency operation.

It is a kind of for removing the method packet of encephalic blood or thrombus from patient in the another embodiment of the disclosure Include: the hole being passed through in patient's skull places introducer；Trochar is placed across introducer；Vltrasonic device is promoted to pass through Trochar is to reach the treatment position in intracranial space；With one or more frequencies between about 1kHz to about 20MHz from Vltrasonic device transmits ultrasonic energy；And blood or thrombus are removed from patient by probe and aperture, probe has service duct And suction passage, suction passage have proximally and distally, service duct has distal end and wall, and suction passage has opening and inner wall Surface, the opening are located at the far-end or adjacent with the distal end of suction passage of suction passage, the distal end phase in aperture and service duct Neighbour is simultaneously connected to the internal flow of suction passage, wherein aperture is configured to be pumped through service duct when pressurized fluid When generate spray pattern so that spray pattern impact in the inner wall surface of suction passage, wherein blood is removed by suction passage Liquid or thrombus.

Detailed description of the invention

Fig. 1 is the schematic diagram for the system according to the disclosure one embodiment for sucking thrombus.

Fig. 2 is to show the schematic diagram in greater detail of the portions of proximal of the system for sucking thrombus of Fig. 1.

Fig. 3 is the schematic diagram of the distal portions of the system for sucking thrombus of Fig. 1.

Fig. 4 is the plane view according to the disposable unit of the system for sucking thrombus of one embodiment of the disclosure Figure.

Fig. 5 is the detailed view of the details 5 of Fig. 4.

Fig. 6 is the detailed view of the details 6 of Fig. 4.

Fig. 7 is the detailed view of the details 7 of Fig. 4.

Fig. 8 is the detailed view of the details 8 of Fig. 4.

Fig. 9 is the plan view of the distal end of the suction lead of the system for sucking thrombus of Fig. 4.

Figure 10 is the sectional view such as the Fig. 9 intercepted by line 10-10 watched in the blood vessels.

Figure 11 is the detailed view of the details 11 of Figure 10.

Figure 12 is the front perspective view according to the pump mount base of one embodiment of the disclosure.

Figure 13 shows the piston of the system for sucking thrombus, is coupled to the bracket of piston pump.

Figure 14 is the viewgraph of cross-section of the distal end of the suction lead of Fig. 9.

Figure 15 is the view for being coupled to the box of pump mount base.

Figure 16 is the sectional view of the box of Figure 15.

Figure 17 is the exploded view of the pump mount base of Figure 12.

Figure 18 is the pressure of piston pump and the curve graph of time relationship.

Figure 19 is the front view of the piston and box according to the piston pump of one embodiment of the disclosure.

Figure 20 is the pressure of piston pump and the curve graph of time relationship.

Figure 21 is the plane view according to the disposable unit of the system for sucking thrombus of one embodiment of the disclosure Figure.

Figure 22 is the detailed view of the conduit of the system for sucking thrombus of Figure 21.

Figure 23 is the detailed view of the pipe sleeve part of the system for sucking thrombus of Figure 21.

Figure 24 is the decomposition view according to the brine pump driving unit of one embodiment of the disclosure.

Figure 25 is the decomposition view of the disposable piston pump head of the salt water pump unit of Figure 24.

Figure 26 is led according to the sucking positioned at the endovascular system for sucking thrombus of one embodiment of the disclosure The sectional view of pipe.

Figure 27 is the sectional view positioned at the endovascular conduit that drug is transmitted to target position.

Figure 28 is the perspective view according to the suction lead of one embodiment of the disclosure.

Figure 29 is the perspective view according to the suction lead of one embodiment of the disclosure.

Figure 30 is the perspective view according to the suction lead of one embodiment of the disclosure.

Figure 31 is the perspective view according to the suction lead of one embodiment of the disclosure.

Figure 32 is the perspective view of the suction lead of Figure 28, wherein significant negative pressure is applied on suction chamber.

Figure 33 is the perspective view of the suction lead of Figure 29, wherein significant negative pressure is applied on suction chamber.

Figure 34 is the perspective view of the suction lead of Figure 30, wherein significant negative pressure is applied on suction chamber.

Figure 35 is the perspective view of the suction lead of Figure 31, wherein significant negative pressure is applied on suction chamber.

Figure 36 is the perspective view of the suction lead of Figure 28, wherein the application negative pressure almost no or no on suction chamber.

Figure 37 is the perspective view of the suction lead of Figure 29, wherein the application negative pressure almost no or no on suction chamber.

Figure 38 is the perspective view of the suction lead of Figure 30, wherein the application negative pressure almost no or no on suction chamber.

Figure 39 is the perspective view of the suction lead of Figure 31, wherein the application negative pressure almost no or no on suction chamber.

Figure 40 is the perspective view of the suction lead of Figure 28, wherein specific underpressure is applied on suction chamber.

Figure 41 is the perspective view of the suction lead of Figure 30, wherein specific underpressure is applied on suction chamber.

Figure 42 is the perspective view according to the suction lead of one embodiment of the disclosure.

Figure 43 is the perspective view according to the suction lead of one embodiment of the disclosure.

Figure 44 A is the end-view according to the suction lead of one embodiment of the disclosure.

Figure 44 B is the longitdinal cross-section diagram according to the suction lead of one embodiment of the disclosure.

Figure 45 A is the end-view according to the suction lead of one embodiment of the disclosure.

Figure 45 B is the longitdinal cross-section diagram according to the suction lead of one embodiment of the disclosure.

Figure 46 A is the longitdinal cross-section diagram according to the suction lead in first state of one embodiment of the disclosure.

Figure 46 B is cut according to the longitudinal direction of the suction lead of Figure 46 A in the second state of one embodiment of the disclosure Face figure.

Figure 47 is the sectional view according to the spray pattern of the suction lead of one embodiment of the disclosure.

Figure 48 is the sectional view according to the spray pattern of the suction lead of one embodiment of the disclosure.

Figure 49 is the partial sectional view according to the spray pattern of the suction lead of one embodiment of the disclosure.

Figure 50 is the partial sectional view according to the spray pattern of the suction lead of one embodiment of the disclosure.

Figure 51 is the partial sectional view according to the spray pattern of the suction lead of one embodiment of the disclosure.

Figure 52 is the sectional view according to the spray pattern of the suction lead of one embodiment of the disclosure.

Figure 53 to Figure 55 is thrombus/grumeleuse section by being treated according to the suction lead of one embodiment of the disclosure Figure.

Figure 56 is the intake system including suction lead and bending mandrel tool according to one embodiment of the disclosure Sectional view.

Figure 57 is the sectional view of the intake system of Figure 56 in deflection state.

Figure 58 is the front view according to the intake system of one embodiment of the disclosure.

Figure 59 A is the suction including suction lead and spin line (spinning wire) according to one embodiment of the disclosure Enter the sectional view of system.

Figure 59 B is the front view of the rotating device of the spin line rotation for making the embodiment of Figure 59 A.

Figure 60 is the system for removing Intracranial thrombus or intracranial hematoma by window, hole or the hole in patient's cranium Sectional view.

Figure 61 is the front view according to the system with multiple fluid sources of one embodiment of the disclosure.

Figure 62 is the front view according to the intake system of one embodiment of the disclosure.

Figure 63 is the longitdinal cross-section diagram according to the suction lead of one embodiment of the disclosure.

Figure 64 is the longitdinal cross-section diagram according to the suction lead of one embodiment of the disclosure.

Specific embodiment

For term defined below, unless giving in claims or in elsewhere in this specification different Definition, otherwise these definition should be applied.

Regardless of whether significantly pointing out, all numerical value is assumed to be modified by term " about " herein.Term What " about " usual expression those skilled in the art may consider is equal to (that is, function having the same or result) with enumerator Numberical range.In many cases, term " about " may include the numerical value for being rounding to immediate effective digital.

By the numberical range that endpoint value is enumerated include within the scope of that all numerical value (such as " 1 to 5 " include 1, 1.5,2,2.75,3,3.80,4 and 5).

As used in this specification and the appended claims, no unless context is clearly stated in other ways Then singular " one (a) ", " one (an) " and " being somebody's turn to do (the) " include multiple objects.Such as this specification and appended claims Used, unless context is clearly stated in other ways, otherwise term "or" usually includes the meaning of "and/or" with it It is used.

The following detailed description should refer to attached drawing reading, and in the accompanying drawings, the label of the similar component in different figures is identical. Attached drawing (it is necessarily proportional) shows illustrative embodiment, and is not intended to limit the scope of the present invention.

Fig. 1 is to show the schematic diagram of auxiliary intake system 10.Intake system 10 includes remote handpiece 12, the long-range hand Gripping member includes fluid pump 26 and operator's control interface 6.In an expected embodiment, system 10 is one be intended for single use Secondary property unit.Intake system 10 may also include extension 14, which includes fluid flushing chamber 2 (or high-pressure injection chamber) and inhale Enter chamber 4, and the extension allows the independent manipulation of conduit 16 without require that in the surgical procedure executed with intake system 10 Period relocates handpiece 12.Extension 14 also acts as accumulator.From pump 26 (pump may include positive displacement pump) outflow High-pressure fluid by pump 26 each stroke carry out pulse, with generate have between each sine wave peaks and troughs it Between significant change sinusoidal pressure map.Extension 14 can be matched with pump 26, consistently to expand with each pumping pulse And contraction, to reduce the variation of the pressure as caused by pumping pulse, thus the end of conduit 16 generate it is smooth or compared with Smooth fluid stream.It can be used with any pipe for properly complying with characteristic.Extension 14 can be permanently attached to pump 26 or it Pump 26 can be attached to by connector 44.Connector 44 is preferably constructed to ensure that extension 14 cannot be improperly attached to Pump 26.

Extension 14 and conduit 16 are bonded together by interface connector 18.In an expected embodiment, interface Connector 18 may include the filter between the high pressure fluid injection chamber 2 of extension 14 and the high-pressure injection chamber 36 of conduit 16 Component 8 (Fig. 3).Conduit 16 and extension 14 can for good and all be engaged by interface connector 18.Alternatively, interface connector 18 It may include standardized interconnecting piece, so that selected conduit 16 can be attached to extension 14.

Be attached to handpiece 12 is fluid source 20 and vacuum source 22.Hospital's bag of saline of standard is used as fluid source 20；This bag is easily obtained for doctor, and provides necessary volume to execute surgical procedure.Dewar bottle can provide vacuum Source 22 or vacuum source 22 can be provided by syringe, vacuum pump or other suitable vacuum sources.

In an expected embodiment, conduit 16 has more soft in far-end from changing to more firmly in proximal end Variable stiffness.The variation of the rigidity of conduit 16 can be by not having the single pipe radially combined real between two adjacent pipe fittings It is existing.For example, the axis of conduit 16 can be made of the metal tube of single length, have the helical cuts of the length along pipe to provide axis It is flexible.Variable stiffness can be generated by changing by the pitch of the helical cuts of the different length of metal tube.For example, spiral is cut Mouthful pitch can device far-end bigger (wherein, the circle of helical cuts is close together) to provide bigger flexibility. On the contrary, helical cuts proximal end pitch can smaller (wherein, the circle of helical cuts is more separated) with provide it is increased just Property.In some embodiments, single sheath can cover the length of metal tube, to provide vacuum-packed catheter shaft.Below The other feature of conduit 16 is described with reference to Fig. 3.

Fig. 2 is to show the schematic diagram in greater detail of the portions of proximal of handpiece 12 and subsidiary conduit intake system 10. Handpiece 12 includes control cabinet 24, and electric power and control system are arranged in control cabinet.In some embodiments, pump 26 can be The positive displacement pump of motor driving with constant output.Aperture of the relationship of pumpage and conduit volume together with conduit high pressure chest 36 Position (Fig. 3) of 42 (outlets) in suction chamber 38 ensures: when essentially all of pressurized fluid is emptied by suction chamber, There is no energy to be transferred to patient from brine pump.Starting button 28 is mechanically connected to main valve 30.When preparation device is for using When, it is advantageous that all air are emptied from pressurized fluid system, a possibility that reduce air embolism.It is pressed by pressing to start Fluid source 20 is connected to vacuum source 22 via pump 26 by button 28, user.This effectively pull fluid (such as 0.9%NaCl solution, Or " salt water " or " physiological saline " or heparinized saline) by entire pumping system, it removes all air and clearly rises Dynamic system is to be used for safety operation.Pressure/vacuum 32 is used to synchronously be switched on and off vacuum with fluid-pressure system.One Expected valve 32 is equipped with the one-way valve of porthole.This valve relative to manually or the valve system of electronics is advantageous, this be because It is used as anti-intervention security feature and mechanically and automatically combining the operation of two main systems for it.By with pressure/ Vacuum valve 32 eliminates a possibility that vacuum is connected in the case where un-activation fluid system.

Operator's control interface 6 is powered by electric system 48 (such as battery or power line), and may include electronic control Plate 50, the electronic control panel can be grasped by the use of one or more switches 52 and one or more indicator lights 54 by user Make.Multiple equipment safety functions are also monitored and controlled in control panel 50 comprising superpressure detection, bubble detection and vacuum gas filling (vacuum charge).Pressure sensor 64 monitors pressure (that is, injection pressure) and senses the presence of bubble.Alternatively Or in combination, Optical devices 66 can be used for sensing bubble.In an expected embodiment, pump pressure is pressed with that is generated Electric current required for power is proportional.Therefore, if electric current required by pump 26 is more than the preset limit, control panel 50 will pass through It shuts off the electric power of pump 26 and disables the pump.Bubble detection can also drive at any particular moment the pump 26 to be wanted by monitoring The electric current asked and be monitored.It, should (it be high almost without or without air in order to which positive displacement pump 26 reaches high fluid pressure Spend compressible) it is present in pump 26 or connection system (including conduit 16 and extension 14).Fluid volume be it is sufficiently small, make Any air in the system of obtaining will lead to does not generate pressure at pump head.Any unexpected decline of control panel monitoring pump electric current becomes Change, decline variation can indicate that air comes into system.If the speed of decline is faster than the preset limit, control panel 50 will The pump is disabled and shutting off the electric power of pump 26, until problem is corrected.Similarly, the bulk in high pressure chest 36 (Fig. 3) Object (it may be the entrance due to the thrombus or solid embolus of systematism or threadiness and is formed) can make pump 26 by monitoring The electric current of operation and be detected.During normal use, it is quite high for pumping 26 current fluctuation.For example, pump 26 can be configured to So that there are 200 milliamperes or bigger of variations in electric current in the normal operation period, so that when current fluctuation declines 200 Milliampere or less when, air is identified and system is closed.Alternatively, the electricity in the range of such as 50 milliamperes to 75 milliamperes Stream fluctuation can be used to identify out has air in systems.In addition, the increase of electric current or current fluctuation can be indicated in high pressure chest 36 Inside there is grumeleuse or thrombus.For example, greater than 600 milliamperes of electric current can indicate thrombus partially or even wholly block high pressure chest 36 or Person even blocks suction chamber 38 (Fig. 3).

The vacuum pipeline 56 for being connected to vacuum source 22 can be connected to pressure sensor 58.If the vacuum degree of vacuum source 22 Lower (that is, absolutely duty pressure has been reduced) or if when detecting the leakage in vacuum pipeline 56, the disabling of control panel 50 pumps 26, Until problem is corrected.Pressure sensor 58 can also be a part of safety circuit 60, will not if vacuum is not present Allow to pump 26 operations.To, Integrative security system 62 (including safety circuit 60, pressure sensor 64 and/or Optical devices 66, And pressure sensor 58) both pump pressure and vacuum pressure are required to run for system.If there is problem (for example, such as Fruit is there are unacceptable low pump pressure or lacks significant vacuum), then control panel 50 would not allow for user's operation intake system 10, until all problems are corrected.This will keep air from being injected into patient, and will guarantee intake system 10 not with Incorrect parameter manipulation.Alternatively, as the replacement to (for example, electrical, optical) is directly connected to, pressure sensor 58 can be configured to any other component (example that wireless signal is sent to control panel 50 or couples or is connected to control panel 50 Such as, antenna), with the operation of long-range control pump 26.No matter pump is in aseptic area or except aseptic area, and long-range control can be with It is possible.

Fig. 3 is the schematic diagram of the distal portions 68 of subsidiary conduit intake system 10, and it illustrates the more details of conduit 16. In some embodiments, conduit 16 is single operation person's exchanging pipe, and the short-length guidewires chamber of the distal end including being attached to device 34.The length of guidewire lumen 34 can be between about 1cm to about 30cm or length can be between about 5cm to about 25cm Between perhaps length can be between about 5cm to about 20cm or length can be about 13.5cm.In other embodiment In, the guidewire lumen (its length for extending conduit 16) of overall length can be used.For example, being dimensioned in peripheral blood vessel (including periphery Artery) on the conduit 16 that uses in combination with overall length guidewire lumen.In some embodiments, suction chamber itself also acts as seal wire Chamber.Suction chamber 38 includes distal openings 40, which allows vacuum (for example, from vacuum source 22) by thrombotic substance It is pumped into suction chamber 38.High pressure chest 36 includes distal port 42, which is arranged near distal openings 40 one and sets It is quantitative.For example, distal port 42 may be provided at about 0.508mm near distal openings 40 (0.020 inch) or 0.508mm ± 0.076mm (0.020 inch ± 0.003 inch) or another desired amount.Aperture 42 is configured to spray across suction chamber, with leaching Solution and/or dilution thrombotic substance, for being for example transported to vacuum source 22 by reducing the effective viscosity of thrombotic substance. The axially placed of fluid orifice 42 to interact preferably generation with the spray pattern of opposite cavity wall by spraying, and not The swirl pattern that embolization material can be forced to go out from distal openings 40.At least when the distal end of conduit 16 is in aqueous environment (such as Body cavity (including blood vessel)) it is interior when, spray pattern may be present.Aqueous environment can be at for example between about 35.0 DEG C to about 40.0 Body temperature between DEG C, or the body temperature between about 36.0 DEG C to about 38.0 DEG C.The system can be configured so that flushing Fluid arrives about 10.342 megapascal (MPa)s (1500 pounds/square inch) with (500 pounds/square inch) of about 3.447 megapascal (MPa)s Between pressure leave pump.In some embodiments, after the head loss along high pressure chest 36, rinse fluid art is about (600 pounds/square inch) of 4.137 megapascal (MPa)s between about 8.274 megapascal (MPa)s (1200 pounds/square inch) or about 4.816 megapascal (MPa)s (650 pounds/square inch) leave aperture between about 5.861 megapascal (MPa)s (850 pounds/square inch) 42。

Fig. 4 shows the system 100 for being used to suck thrombus according to one embodiment of the present invention.It is used shown in Fig. 4 Disposable unit 101 is represented in the system 100 of sucking thrombus comprising pipe sleeve part 103 and suction lead 118, the system is by structure It causes to be attached to vacuum source 22, fluid source 20 (Fig. 1 and Fig. 2), pressure monitor (not shown) and pump mount base 200 (Figure 12). System 100 for sucking thrombus is further configured to be used together with seal wire.Started with the component of pipe sleeve part 103, pointed section (spike) 102 (illustrating in greater detail in Fig. 5) are configured to be coupled to fluid source 20, such as bag of saline.Bag of saline can have Equal to the brine volume of about 1000ml or about 500ml.Salt water may include physiological saline, and can by test tube of hepari, or Person may include one or more therapeutic agents.Other fluids can be used to replace physiological saline or saline mixture, including cream Sour Ringer's solution, hypertonic saline, or even the solution comprising blood product.Salt water (or other fluids) can be at room temperature, or (for example, permanently or temporarily to increase or decrease activity) can be heated or cooled.The connector 104 of such as luer connector (illustrating in greater detail in Fig. 7), which is constructed, is coupled to vacuum source 22.Vacuum source 22 can be have between 20ml to 500ml it Between volume Dewar bottle.Vacuum source 22 is alternatively 60ml syringe, and plunger is taken out after being coupled to connector 104 It draws and returns.This can be lockable plunger, be locked to keep the plunger position of emptying.In some cases, vacuum Source 22 can be 20ml syringe or 30ml syringe.A kind of Exemplary syringe with lockable plunger is by Utah, U.S.A What the value medical system limited liability company of state south Jordon soldSyringe.Vacuum source 22 can also be have Or the not no vacuum pump of collection vessel.Capableing of the pressure sensor 106 of measurement of vacuum, (including positive pressure sensor, the positive pressure pass Sensor is configured to measurement positive pressure but can measure negative pressure) vacuum pipeline 108 is coupled to via y type connector 110.From pressure The signal of force snesor 106 is advanced along cable 112 (Fig. 7), which also supplies voltage to pressure sensor 106.Connector 114 Cable 112 is coupled to pressure monitor or is coupled to pump mount base 200 by (being also shown in FIG. 6).Box 116 is disposable unit, It is attached to pump mount base 200 (Figure 12), for allowing the vasopressing injection of liquid injectate (such as salt water).More in conjunction with Fig. 6 Box 116 is described in detail.The suction lead 118 with distal end 120 is illustrated in greater detail in fig. 8.

Fig. 5 is gone to, pointed section 102 is connected to extension 122.Liquid injectate is downstream pumped at piston pump, should The more liquid injectates of piston pump pull (such as liquid injectate from bag of saline) pass through check-valves 126 and pass through supply Pipe 130.Inlet 128 can be used for being injected into other materials in system or being used for removing air or starting system.Pointed section 102 Removable pointed section protection cap 124 can be packaged with.

As shown in fig. 6, box 116 is from 130 pull liquid injectate of supply pipe and (in combination with pump mount base 200) is to injection Pipe 152 pressurizes.The more details of box 116 will be described together with the description to entire piston pump.Fig. 7 is shown for measuring The more details of the pressure sensor 106 of vacuum degree.Pressure sensor 106 is connected to y type connector by Luer coupler 154 110.Injection-tube 152 and vacuum pipeline 108 are connected to the chamber of catheter shaft 142.For example, injection-tube 152 can be fluidly coupled to distal side Supply pipe 168 (Fig. 9 to Figure 11), such as with high-strength thin-walled polyimides or stainless steel or Nitinol pipe.Distal side supplies Should pipe 168 can be placed in catheter shaft 142, and have between them and form ring part (Fig. 9 to Figure 11) of suction chamber 160. Strain relief 156 protects catheter shaft 142 from kink and other damages.It is used in Luer coupler 154 (in any interconnecting piece Place) in the case where, customization Rule part with additional O-ring can be used, to allow interconnecting piece to be subjected to raised pressure.One In a little embodiments, customized connector can be used, to increase high pressure endurance.In some embodiments, it can be achieved that up to 6.89 megapascal (MPa)s (1200 pounds/square inch) or bigger pressure, without generating leakage or the disengaging of conduit will not be caused.

Fig. 8 is turned to, suction lead 118 is shown as single operation person's exchanging pipe, and including the one of suction lead 118 The wire leading pipe 132 of distal end 120 is attached on side.The length of wire leading pipe 132 can between about 1cm to about 30cm, or Length can perhaps length can be between about 5cm to about 20cm or length between about 5cm to about 25cm It is about 13.5cm.Wire leading pipe 132 has distal end 136 and proximal end 138, and single guidewire lumen 134 is between both ends 136,138 Pass through.Guidewire lumen 134 can be configured to compatible with 0.014 " seal wire, 0.018 " seal wire or a variety of other seal wire diameters.Intracavitary diameter 0.406mm (0.016 inch) be may be about for compatible with 0.014 " seal wire.Wire leading pipe 132 can be constructed by multiple material, These materials include nylon, polyethylene,Polyester, PET or the wire leading pipe can be by synthetic or coextrusion materials Material construction.For example, internal layer may include high density polyethylene (HDPE) or FEP, PTFE, ETFE or the other materials for high-lubricity, and And outer layer may include PEBAX, nylon or other materials, to be used for combined machine intensity and flexibility.Between the inner layer and the outer layer may be used Use articulamentum (tie layer), such as linear low density polyethylene.Conduit 118 may include composite conduit axis 142, this is compound Catheter shaft has the inner supporting structure 144 for being covered with polymer jacket 146.Inner supporting structure 144 can be tubular braid or Person's one or more spiral winding, for example, being made of the flat wire or round wires of stainless steel.Inner supporting structure 144 can also be spiral shell Rotary-cut mouth hypodermic tube, such as be made of 304 stainless steels or NiTi.Helical cuts hypodermic tube can have to be surveyed in proximal end About 4 millimeters to 6 millimeters of amount or about 5 millimeters pitches are transitioned into being used for increased rigidity in inner supporting structure 144 Distal end 150 at the about 0.75mm that measures to 1mm's or the pitch of about 0.87mm.The pitch section different positioned at the two Between can be middle node away from section, which is, for example, the section having between about 2mm to about 5mm away from section Away from a section and another section with the pitch between about 1mm to about 2.5mm.Inner supporting structure 144 can terminate In transition region 148, so that polymer jacket 146 individually extends to the distal end 136 of suction lead 118.More in conjunction with Fig. 9 to Figure 11 Describe catheter tip part 140 in detail.

Fig. 9 to Figure 11 shows the open distal end 158 of the suction chamber 160 for sucking thrombus.Skiving portion (skive) 162 may be formed in polymer jacket 146, to assist being inhaled into sucking by the combination of the vacuum generated by vacuum source 22 The entrance of thrombus 164 in chamber 160 (on the direction of arrow 180).Skiving portion 162 also make open distal end 158 be sucked to Chance by vascular wall 166 minimizes.Distal side supply pipe 168 has closed distal end 170, for example, it can make during manufacture It is blocked for adhesive, epoxy resin, hot melt adhesive or interference member.Alternatively, distal side supply pipe 168 can be by molten Change its a part and is closed.Distal side supply pipe 168 includes chamber 176, which extends in the length of distal side supply pipe；With And aperture 172, the aperture it is neighbouring and close to the wall 174 for passing through distal side supply pipe at the position of closed distal end 170 shape At.The diameter in aperture 172 can between (0.002 inch) of about 0.0508mm between about 0.1016mm (0.004 inch) or Person is about 0.0787mm (0.0031 inch).The internal diameter of distal side supply pipe 168 can be between about 0.3048mm (0.012 inch) About 0.4318mm is arrived between about 0.4826mm (0.019 inch) or between (0.014 inch) of about 0.3556mm It between (0.017 inch) or is about 0.3937mm (0.0155 inch).The chamber 176 of distal side supply pipe 168 is derived from fluid The continuation of the entire flow path in source 20, the entire flow path include the inside of extension 122, supply pipe 130, box 116 And injection-tube 152.In some embodiments, the chamber 176 of distal side supply pipe 168 can be tapered (taper is tapered), example Such as, proximally the internal diameter of the about 0.3937mm (0.0155 inch) at part tapers at distal portions about The internal diameter of 0.2974mm (0.011 inch).In some embodiments, being tapered the equivalent in portion can be by by different-diameter Pipe be bonded to each other and obtain, with formed staged reduction bore.In some embodiments, the gradually change of different-diameter Thin pipe can be bonded to each other, with the combination reduced with staged that is tapered for diameter.As combined described in piston pump, The pump of about 4.137 megapascal (MPa)s (600 pounds/square inch) to about 5.516 megapascal (MPa)s (800 pounds/square inch) exports Pressure wave makes liquid injectate flow through the flow path (arrow 182) including distal side supply pipe 168, and makes fluid Jet stream 178 at a high speed leaves aperture 172.Not over the stream of suction chamber 160 (for example, if without vacuum), Fluid jet 178 will impact the inner wall 181 of the proximate orifice 172 of suction chamber 160.According to existing vacuum degree, fluid jet can It can be bent as shown.Fluid jet 178 is used to be macerated the thrombus 164 for entering suction chamber 160 and dilutes it.Liquid The flow velocity and vacuum degree of infusion (such as salt water) are controlled such that flow through the salt water of nearside suction chamber 160 and blood About the 50% to 70% of the volume of mixture is blood.Alternatively, about the 60% of volume is blood.The maceration and dilution guarantee There is the continuous stream for passing through suction chamber 160, so that it will not be blocked.Fluid jet 178 is configured to be comprised in sucking In chamber 160, and it will not escape in blood vessel or other body cavitys.

The axial centre in aperture 172 nearside Yu open distal end 158 nearest side section at a distance of about 0.3302mm (0.013 inch) to about 0.8382mm (0.033 inch), or about 0.4064mm (0.016 inch) to about 0.6604mm (0.026 inch), as shown in the distance D in Figure 11.Figure 14 is catheter tip part 140 at the axial centre in aperture 172 Cross section.Aperture 172 is substantially oriented along the vertical center line 184 of suction chamber 160, or is located in the range of ± a, wherein angle Spending a is about 20 °.In various embodiments, angle a can be between about 1 ° to about 45 ° or at about 20 ° to about Change between 35 °.Wire leading pipe 132 can be fixed to polymer jacket 146 by being attached material 186, and the attachment material is all for example Adhesive, epoxy resin, hot melt material or other materials.Wire leading pipe 132 can be fixed along its whole length, or along its length It is fixed at the discrete location of degree, to make flexible maximization.Distal side supply pipe 168 can be fixed on by being attached material 188 In suction chamber 160, all for example adhesives of the attachment material, epoxy resin, hot melt material or other materials.Polymer jacket 146 It may include a variety of different materials comprising PEBAX, nylon or polyurethane.In some embodiments, polymer Sheath can partly be fused to distal side supply pipe 162 and/or wire leading pipe 132, to minimize the wall thickness of component.

Figure 12 shows the pump mount base 200 of the box 116 for coupling the system 100 for sucking thrombus.Shell 202 is attached It is connected to IV rod chucking appliance 204, and includes control circuit and the motor (Figure 13) for operating piston pump system 300, the piston pump System includes combined pump mount base 200 and box 116.By the effect of motor and cam in pump mount base 200, bracket 206 is in window It is activated periodically (up and down) in 208, to move the piston 210 (Figure 13) in box 116.The spike 212 of box 116 is inserted into In cavity 216 in pump mount base 200.Bias buckle 214 is locked in one or more grooves 218 in pump mount base 200.Cavity 216 or groove 218 can have existing one or more switches of sensing box 116.For example, the box for a specific model can With the first quantity spike 212 or bias buckle 214 (or a combination thereof), and another specific model can have different number Spike 212 or bias buckle 214 (or a combination thereof), this is identified by system.The smooth surface of elastomer frame 222 The edge 220 of 224 engagement boxes 116, for reinforcing protection.Upper space 226 is configured to engage or be closely matched supply Pipe 130, and lower space 228 is configured to engage or be closely matched injection-tube 152.Bracket 206 has semi-cylindrical Cavity 236, the cavity are snapped in the cylindrical engagement surface 238 on piston 210.Bracket also has top edge 240 and lower edge 242, the top edge and lower edge are respectively used to the first adjacency section 244 and the second adjacency section 246 of axially engaging piston 210. User interface 230 in pump mount base 200 has one or more buttons 232 and an one or more indicators 234, the button and Indicator allows the operation of user's operation and assessment system 100.For example, button may include start button for beginning pumping, For stopping the stop button of pumping, for fluid infusion starting system and the starting button that air clean is gone out or Interim pause button.Other data entry keys are also possible.Box 116 may include one or more interface units 248.For example, Resistor, when box 116 is attached to pump mount base 200, pump mount base 200 can measure the value of the resistor via contact 247,249. This allows pump mount base 200 to determine the correct parameter for operating the system 100 of specific model.For example, the with first resistor One resistor can be used together with the first model, and the second resistor with second resistance can make together with another model With.Alternatively, interface unit 248 is in combination with RFID chip, such as reading RFID chip or read/write RFID chip.This is allowed Specific data (pump operating pressure, RPM of motor output etc.) is recorded in pump mount base or to the hardware and knowledge connected Not each patient.

Figure 15 and Figure 16 show boxes 116, and wherein its most of internal parts are visible.Figure 16 is cutting for box 116 Face figure.Box 116 includes internal supply cylinder 252 and internal injection cylinder 254, and inside supply cylinder and internal injection cylinder are in box 116 The circular cylindrical cavity of extension.Piston 210 include supply side axle 256 and injection side axle 258, supply side axle 256 include for confession The O-ring 266 for answering cylinder 252 sealably to engage, and injecting side axle 258 includes for sealably engaging with injection cylinder 254 O-ring 268.Each of O-ring 266,268 is located at cylindrical recessed around each corresponding shaft portion 256,258 In slot 290,292.When moving on piston 210 in a first direction 276, internal ball valve 272 (Figure 16) prevents infusion (salt water) The inner passage 274 in the supply side axle 256 of piston 210 is flowed through, but when piston 210 moves in second direction 278, Internal ball valve 272 allows infusion to flow through inner passage 274 and by the inner passage 282 in injection side axle 258.Ball valve 272 are axially retained in the spheric annulus recess portion 284 in the inside for being located at injection side axis 258 and are located in supply side axle 256 The recess portion 286 with through channel (thru channels) between.Supply side axle 256 and injection side axle 258 can pass through screw thread It connects 288 and is held together.When being moved on piston 210 in a first direction 276, the injection side axle 258 and O of piston 210 Shape ring 268 forces infusion to pass through injection-tube 152.Protection pipe 280 is illustrated on injection-tube 152.In Figure 15, side axle is injected 258 are illustrated at the bottom of injected pulse.Infusion is filtered by inline filter 262, which can be 40 Micron is to 50 micron filters, the thickness with about 0.762mm (0.030 inch).Inline filter 262 is configured to protect It holds particle and leaves infusion.Even if infusion is circulated through suction lead 118 and does not enter in blood vessel, by embedded mistake Filtering provided by filter 262 is also additional security step.However, the step helps ensure that particle does not block microstome 172 (Figure 11).When piston 210 moves in second direction 278, the supply side axle 256 and O-ring 266 of piston 210 are being supplied It is sealably moved together in cylinder 252, but ball valve 272 allows infusion to be advanced through the inner passage 274,282 of piston 210 simultaneously And filling injection cylinder 254.Infusion can by check valve assembly 270, (component includes O-ring 264 and stops from supply pipe 130 Return valve 250) enter.Check-valves 250 allows infusion to enter the inside of box 116 from supply pipe 130, but is not moved to from box 116 Supply pipe 130.Check-valves 250 can be configured so that air at least partially due to its low viscosity and check-valves cannot be caused 250 mobile (openings) thus do not allow air propulsion to pass through system.In some embodiments, piston 210 can be with hole Single piece (integral type) design, check-valves is press fit into or is integrated in the hole.The check-valves mutually compatible with this component can It is provided by the Li Shi company of Connecticut, USA Peter Westbrook.

The range of the volume of the infusion of each periodic injections can be for from about 0.02ml to about 41ml, or for from about 0.04ml to about 2.0ml, or be about 0.06ml to about 0.08ml, or be about 0.07ml.The available body of injection cylinder 254 Product (volume of injectable) can be configured to the volume available (fillable volume) for being less than supply cylinder 252, to ensure to inject The sufficient filling of cylinder 254.For example, the volume available of injection cylinder 254 may be about 0.05ml to about 0.12ml, and supply cylinder 252 volume available may be about 0.07ml to about 0.16ml.It is contemplated that volume available ratio R_UIt is arrived between about 1.15 It between about 2.00 or between about 1.25 to about 1.85 or is about 1.40, in which:

R_U=V_SCU/V_ICU, in which:

V_SCUThe volume available of=supply cylinder 252, and

V_ICUThe volume available of=injection cylinder 254.

Mean flow rate is between about 5ml/ minutes to about 100ml/ minutes.It is some being applied for coronary artery In embodiment, it can be within 20ml/ minutes desired.In some embodiments applied for periphery, 50ml/ minutes It can be desired.

Figure 18 shows the curve graph 600 of the pressure (P) of piston pump and the curve 602 of time (T).The wave crest of curve 602 604 and trough 606 may depend on piston pump piston and cylinder design, be particularly depending on volume available ratio R_U.Go to figure 19, it shows piston 608, has in compressed O-ring 601,603 (when in the cylinder 605 and 607 for being placed in box 609) The first diameter D that place measures₁With second diameter D₂.Therefore, the diameter of cylinder 605,607 is also defined as diameter D₁And D₂.Work as cylinder 605,607 diameter D₁、D₂And length is adjusted so that volume available ratio R_UWhen optimised as previously mentioned, it can produce Curve 610 as shown in figure 20.Curve 610 has the wave crest 614 and trough 616 of less restriction, and therefore generates fluid amplitude Small change and the injection that more balances.

The pump mount base 200 partly decomposed in Figure 17 shows the inside of linear (upper and lower) actuating for bracket 206 Mechanism, the internal mechanism are attached to trestle table 310.Motor 302 is controlled by circuit board 304 and by the (figure of user interface 230 12) it operates, the indicator 234 of user interface illuminates by LED 306.Motor 302 rotates cam 316, including path 330.Trestle table 310 has the pin 318 extended from rear side.Pin 318 can 310 press fit of trestle table, in conjunction with or be screwed in Position.Trestle table 310 can be fixed to two sliding parts 312,314 with screw through hole 326,328, so that the rotation of cam 316 Movement causes pin 318 to be advanced along the path of cam 316 330, thus cause to be attached to the trestle table 310 of sliding part 312,314 with Periodic motion slides up and down.The shape of cam has determined the amount of acceleration and deceleration in movement.322 He of upper post Lower post 324 is used as guide portion and/or the stopper section of trestle table 310.The connection of pressure sensor 106 for measurement of vacuum Device 114 can be inserted into socket 308 (being also shown in FIG. 12), and signal relevant to pressure can be by circuit board 304 Reason.Entire pump mount base 200 is reusable.

The size and/or shape of the in-profile diameter of cam 316 can be set to control piston 210 length of stroke and The amount (that is, difference between high pressure and low pressure) of pulsation.In some cases, reducing length of stroke reduces the amount of pulsation.? In application (such as coronary artery application) in heart, the amount for reducing pulsation can reduce the incidence of bradycardia.In order to compensate for Lower length of stroke and the enough overall flow rates of holding, such as (by transmission device or led to by increasing motor output speed Cross increased application voltage) rotation speed (that is, rev/min) of cam can be increased.

Another embodiment of the system 800 for sucking thrombus is shown in FIG. 21.System for sucking thrombus 800 include three main components: pump mount base 200, suction lead 818 and the pipe sleeve part 803 of Figure 12.Suction lead 818 and pipe External member 803 represents disposable unit 801, and pump mount base 200 is reusable component.When pump mount base 200 is in validity period Between when being maintained in non-sterile area or region, not necessarily sterilize to pump mount base.Suction lead 818 and pipe sleeve part 803 are passing through It may be provided as after ethylene oxide gas, electron beam, gamma or other sterilization methods sterile.Suction lead 818 Can be separately packaged with pipe sleeve part 803 and supply or suction lead 818 and pipe sleeve part 803 can be packaged together and together by Supply.Alternatively, suction lead 818 and pipe sleeve part can be separately packaged, but be supplied to (that is, binding) together.Such as Figure 21 With shown in Figure 22.Suction lead 818 and pipe sleeve part 803 share feature identical with the suction lead 118 of Fig. 4 and pipe sleeve part 103 In many features, but be configured to allow for being more easily separated each other and additional surgical procedure adaptability.Suction lead 818 have distal end 820 and proximal end 819, this distally includes the wire leading pipe 832 with distal end 836, which includes that y type connects Connect device 810.The catheter shaft 842 of suction lead 818 is connected to y type connector 810 via protectiveness strain relief 856.At it In its embodiment, catheter shaft 842 can be attached to y type connector 810 by Luer coupler.Y type connector 810 may include and lead Pipe supplies first female Rule part 851 of chamber (such as in the conduit 118 of Fig. 4, Fig. 8 to Figure 11) connection, and sucks with conduit Second female Rule part 855 of chamber (such as in the conduit 118 of Fig. 4, Fig. 8 to Figure 11) connection.

Figure 23 is gone to, pipe sleeve part 803 is illustrated in greater detail.Pointed section 802 for being coupled to fluid source 20 (Fig. 1) is permitted Perhaps fluid is entered by extension 822 and check-valves 826 and is reached in supply pipe 830.Optional injection port 828 allows object The injection of material or the removal of gas, as described in previous embodiment.Box 816 is used in combination with pump mount base 200, And the box is structurally and functionally similar to box 116 of the Figure 15 into Figure 16.Fluid is pumped into injection-tube 852 from box 816. Male Rule part 854 is configured to be attached to female Rule part 851 of y type connector 810.

It returns to Figure 21, shows attachment 857, be intended to answer vacuum source 22 (including the syringe 849 with plunger 867) For conduit 818.Syringe 849 is attached to syringe extension 859 via Rule part 865 of syringe 849.Air flow switch (stopcock, plug valve) 847, which can be used for controlling holding vacuum or plunger 867, can be locked out the plunger of type.Syringe Rule part 861 that extension is in charge of 859 is connected to pressure sensor 806, and pressure sensor 806, which has, to be used for and vacuum pipeline Male Rule part 863 that 808 connector (for example, female Rule part) 804 connects.Positioned at the end of vacuum pipeline 808 Male Rule part 853 can be removably fixed to female Rule part 855 of the y type connector 810 of suction lead 818.It comes from The signal of pressure sensor 806 is transported to connector 814 by cable 812.Connector 814 is inserted into pump mount base 200 In socket 308 (Figure 12).Signal relevant to pressure can be handled by the circuit board 304 of pump mount base 200.Pressure sensor 806 can It powers via cable 812 from pump mount base 200.Attachment 857 can also provide sterilizing to user.

In use, pump mount base 200 is placed in outside aseptic area.Because the operation of pump mount base 200 can depositing by pressure Or missing and controlled, so the user just to work in aseptic area can without contact non-sterile pump mount base 200 the case where Lower opening shuts down pump.For example, pump can and applying the vacuum plunger 867 of syringe 849 (for example, pull) in system by Starting.Pump can and then (be unlocked the plunger 867 of syringe 849 and allow to discharge or open air-flow by the vacuum on removal system Switch 847) and be stopped.Syringe 849 or combined syringe 849 and air flow switch 847 can be used as the sterilizing of pump mount base 200 On/off button.Alternatively, suction lead 818 can initially be used in the case where no pump mount base 200, wherein only sucking It is applied to suction chamber.If the distal end 820 of suction lead 818 can in some cases, if suction chamber becomes blocked It can be retreated by thrombus, and pump mount base 200 and pipe sleeve part 803 may be coupled to suction lead 818, will pass through compulsory salt water note It penetrates to operate to be used for increased sucking and clear up suction chamber.This, which will be additionally aided, prevents any thrombus of blocking suction chamber from exempting from In the blood vessel for being unexpectedly transported to patient.

Figure 24 and Figure 25 shows brine pump driving unit 400, has completely disposable pump head 500.Brine pump drives Moving cell 400 is configured to can be with other realities of conduit 116,118 described herein or the intake system injected including fluid The mode of applying is used together.In Figure 24, bottom case 402 and the top shell 404 with label 406 are fixed together by screw 408.? What is accommodated in bottom case 402 and top shell 404 is battery pack 410 and electronic control module 412.Battery cover 416 keeps battery pack 410 In place.In some embodiments, battery pack 410 can provide the voltage of 18 volt DCs, but utilize the system of other voltages It is feasible.The operation of the starting brine pump driving unit of user interface 414.When Dewar bottle is combined as vacuum source 22, Dewar bottle casing 418 can be used.Pointed section 420 can be connected to fluid source 20, and fluid infusion passes through from fluid source 20 Extension 422 reaches disposable piston pump head 500.Salt water can be retouched by the system by being directed to aforementioned embodiments herein Automatic starting (" the self-starting ") system start stated, or can origin make by oneself above system rest part (such as positioned at On IV bar) gravity of bag of saline and started.Valve on the lowermost part of system can be opened, to start entire system System.

As shown in Figure 25, disposable piston pump head 500 is configured to be coupled to the motor drive shaft 504 of motor 502, the horse Electric power is provided up to by the battery pack 410 of brine pump driving unit 400.The motor board 506 and main body of disposable piston pump head 500 508 are fixed to each other by screw 510, and keep the internal part of disposable piston pump head 500.First and second movable heads 512, it 514 is held together by screw 516 and from the boss 518 that the first movable head 512 extends.First and second with Movable plate 512,514 rotationally keeps cam 520.Cam can be asymmetric (as shown in the figure), or alternatively may be used To be symmetrical.Asymmetry can be combined to control pump in noisiness, for customized pressure wave shape profile, And the profile of the shape of the function for customized pump.First and second bushings 522,524 are rotatably retained at first On the second pin 526,528.The insertion of pin 526,528 is located at the circular cylindrical cavity 530,532 in each movable head 512,514 In.

In use, disposable piston pump head 500 is attached to by user and making motor board 506 close to motor drive shaft 504 The motor 502 of brine pump driving unit 400, so that the d shape hole 534 in cam 520 can be crushed on d shape motor drive shaft 504.It can replace Dai Di, d shape can be other non-circular shapes, including but not limited to ellipse, oval or rectangular in shape.In operation, motor 502 makes Motor drive shaft 504 rotates, which in turn rotate cam 520.Cam 520 rotates, and forces bushing 522,524 in a first direction 536 and second direction 538 go forward after push the first and second movable heads 512,514.Bracket 544 is carried on the second movable head On 514, and piston 210 can be coupled to bracket 544 with herein for identical mode described in other embodiment.Position Supply cylinder 552 and injection cylinder 554 in main body 508 are similar to the supply cylinder 252 and injection cylinder 254 of the box 116 of system 100. The piston 210 of box 116 can be used in disposable piston pump head 500.Tape label component class related with piston 210 in Figure 25 It is similar to for component described in the piston 210 in Figure 15 and Figure 16.The size and/or shape of the overall diameter of cam 520 can be set It is set to the length of stroke of control piston 210 and the amount (that is, difference between high pressure and low pressure) of pulsation.In some cases, Reducing length of stroke reduces the amount of pulsation.In application (such as coronary artery application) in heart, the amount for reducing pulsation can Reduce the incidence of bradycardia.In order to compensate for lower length of stroke and enough overall flow rates are kept, such as pass through increase Motor output speed (by transmission device or passing through increased application voltage) can increase cam rotation speed (that is, rev/min Clock).For vacuum pointed section 546 for being coupled to vacuum source 22, which is, for example, the vacuum being maintained in Dewar bottle casing 418 Bottle.Vacuum switch valve 540 (it overcomes the bias of spring 542 and is activated) can be used for allowing pumped work.For example, electronic control mould Block 412 can be configured to automatically start when vacuum switch valve 540 sends signal corresponding with the movement of vacuum switch valve 540 The operation of motor 502, this occurs when obtaining significant vacuum degree.The control can be alternatively, or in addition for from vacuum The control of pressure sensor (such as pressure sensor 106).The opening of vacuum can be used for opening simultaneously motor 502 as a result, so that Single input starts the operation of brine pump driving unit 400.In addition, when measuring the smallest injection by additional pressure sensor When pressure, vacuum source 22 can be controlled by electronic control module 412 (for example, by opening or closing solenoid).For example, when surveying When obtaining the pressure of about 0.62 megapascal (MPa) (90 pounds/square inch) or bigger, vacuum can be activated or be communicated in system.Salt The advantages of water pump driving unit 400 is that user only needs for single component to be assembled on the axis 504 of motor 502.

As described earlier, the system of any embodiment according to the present invention can be configured so that, not same When vacuum be applied in sucking in the case where, the active Flow of salt water (or other) infusion is impossible.Moreover, this is System can be configured so that in the case where the flowing of no salt water (or other) infusion, sucking is impossible.According to this The system of any embodiment of invention can be configured so that, electric current that pump is driven (such as to motor 302,502 into The electric current of row driving) it is monitored or passes through any alternative monitoring method, so that when the change (example of occurrence condition Such as, the air in injected system or the blocking in any of catheter lumen or extension or the leakage in system) when be System is shut down, to avoid such as air from being injected into blood vessel or the event of conduit or the system failure.

Figure 26 shows the suction lead 700 being inserted in blood vessel 165.Suction lead 700 includes being fixed to sucking to lead The guidewire lumen 702 of the distal end 704 of pipe 700 allows suction lead 700 in the enterprising line trace of seal wire 706.Supply chamber 708 is consolidated It is scheduled in suction chamber 710.Supply chamber 708 extends through the pipe 712 being tapered.In some embodiments, it is tapered Pipe 712 can be made of polyimides.In some embodiments, the pipe 712 being tapered can have from its proximal end to its distal end The intracavitary diameter gradually decreased.For example, in some embodiments, intracavitary diameter can be from about 0.3937mm (0.0155 inch) gradually It reduces to about 0.2794mm (0.011 inch).Supply chamber 708 is roughly parallel to the extension of suction chamber 710, but the pipe being tapered The inner wall surface 716 of 712 distal end 714 towards suction chamber 710 is bent, and thus allows to supply the effect of open end 718 of chamber 708 In the aperture of application spray pattern 720.The open end 718 for supplying chamber 708 can be less than about 0.203mm (0.008 English by having It is very little) internal diameter and further promote jet stream or jeting effect.In some embodiments, the open end 718 for supplying chamber 708 can have There is the internal diameter between (0.003 inch) of about 0.076mm to about 0.102mm (0.004 inch).In some embodiments In, the center in 718 aperture of open end nearside Yu the open distal end 722 of suction chamber 710 nearest side section 724 at a distance of about 0.3302mm (0.013 inch) to about 0.4826mm (0.019 inch), as shown in the distance D in Figure 26.In shown reality It applies in mode, the farthest side section 726 of the open distal end 722 of suction chamber 710 departs slightly from nearest side section 724, and thus With angled skiving portion, but the skiving portion angle A_sLess.It can be used between about 75 ° to about 89 ° or be situated between Skiving portion angle A between about 80 ° to about 85 °_s, to allow pull into the open distal end 722 of suction chamber 710 Most of thrombus by high speed exit jet stream (such as salt water) issue (struck), as figure use spray pattern 720 shown by 's.

Figure 27 shows the conduit 700 of Figure 26, is used to reaching drug 730 into the target position 732 in blood vessel 165.Mesh Cursor position 732 may include atherosclerotic lesion portion (atherosclerotic lesion) 728 and/or thrombus 734.However thrombus Sucking (such as in Figure 26) be related to initiatively applying on suction chamber 710 vacuum (for example, from vacuum source), by using identical The drug conveying (as shown in Figure 27) of conduit 700 allows to treat the high-precision volume flow for the drug 730 being transmitted in blood vessel The metering of speed.This is by the way that lesser vacuum significantly is applied to suction chamber 710 or is applied to suction chamber without vacuum come real Existing.Effective use to typically more expensive drug is provided to the accurate measurement of lesser controlled volume and makes to waste Minimal drug.Further, since the diameter of supply chamber 708 is relatively small, relatively small volume or the dead zone for supplying chamber are true It protects and may even happen that the very small unexpected injection of volume when stopping and being transfused drug 730.

In some embodiments, drug 730 can be transmitted with body temperature.In other embodiments, drug 730 can be added Heat, and with the transmission of raised temperature, such as to increase the activity of drug and effect.This can be used to for example in lesser medicine More effective dosage is obtained in the case where object product.In other embodiments, drug 730 can be cooled and with reduced temperature Spend (that is, temperature relative to hypothermia) transmission.Drug 730 can be cooled to control activity level or postpone the activity of drug (for example, make it in downstream effective by the untouchable position of conduit 700).In some cases, drug 730 can be cold But, to apply associated treatment cooling effect in just treated tissue.In some cases, treatment cooling effect can be single Solely realized from cooling salt water or other aqueous non-drug media.

Some including thrombolytic agent (anti-agglomeration drug) in the drug 730 that can be transmitted, such as streptokinase, tissue are fine Plasminogen activator (t-PA), recombinant or genetic engineering tissue plasminogen activator, Tenecteplase (TNK), urokinase, Portugal Grape coccus kinases and Reteplase.Alternatively, stem cell or " the cocktail type mixing medicine containing stem cell (cocktails) " it can be transmitted.In some cases, glycoprotein inhibitors (GPI) can pass through the supply chamber of suction lead 700 708 are injected.Salt water or other aqueous solution can be transferred separately, for carrying out at target position 732 to blood Selective dilution.In some applications, can be used can for example be presented phase change when its pressure or temperature are changed Solution.In such applications, injectable becomes gas when leaving microstome (such as at the open end 718 for supplying chamber 708) Liquid.Alternatively, injectable becomes liquid when being forced past microstome (such as supplying the open end 718 of chamber 708) Gas.Drug 730 or other materials be injected in the blood vessels by conduit 700 application in it is any in, drug 730 Or the injection of other materials can before sucking surgical procedure, period, later or substitution sucking surgical procedure and occur.It returns Suction lead 818 to Figure 21 to Figure 22, if expectation transmits downwards drug simultaneously along supply chamber during sucking surgical procedure It reaches in blood vessel, then pipe sleeve part 803 can be by making the female Rule of male Rule part 854 of pipe sleeve part 803 from suction lead 818 Part 851 is disconnected and is removed from suction lead 818, and drug can be injected directly into supply at female Rule part 851 In chamber, for example, by syringe or including syringe/syringe pump combination metering system.By also from the recessed of suction lead 818 Formula Rule part 855 removes vacuum source, when suction chamber now acts as overflow part, so that being sent to patient (for example, in blood In pipe) in fluid be maintained at controllable rate.It is relatively very small for supplying the volume of chamber, therefore only needs smaller size smaller Drug fill supply chamber, and thus reach the distal crown of suction lead 818.At the end of surgical procedure, few medicine Object is wasted or few drug needs are disposed, to allow very economical effective surgical procedure.

In implementations described herein, sterile fluid path is provided, which extends to from fluid source 20 The open distal end 158 of distal openings 40/ of conduit 16,118.System 100, the system 800 of Figure 21 to Figure 23 in Fig. 4 to Figure 17 Embodiment and Figure 24 to Figure 25 embodiment in, disposable conduit and disposable pump's external member are configured to be supplied as Sterile, and it is coupled to non-sterile (reusable) pump mount base 200 or pump motor 502.These combinations allow more expensive The reusability of component, and allow the reusability (and maximizing aseptic) of more inexpensive parts, thus simultaneously Maximize cost control and patient safety.Figure 61 is turned to, the system 1500 including suction lead 1502 includes first fluid Source 1504 and second fluid source 1506.Pipe sleeve part 1508 with the first pointed section 1510 and the second pointed section 1512 is configured to It is couple to the first interface 1514 in first fluid source 1504 and the second interface 1516 in second fluid source 1506.Pipe sleeve part 1508 is also Including y shape accessory 1518, with for receiving the fluid from first fluid source 1504 and second fluid source 1506, and pass through The supply chamber 1520 of suction lead 1502.First fixture 1522 can be used for opening or closing the confession from first fluid source 1504 It answers, and the second fixture 1524 can be used for opening or closing the supply from second fluid source 1506.In the first scenario, first Fixture 1522 is opened, and the second fixture 1524 is closed, and therefore the fluid only from first fluid source 1504 advances to sucking The supply chamber 1520 of conduit 1502.In the latter case, the first fixture 1522 is closed, and the second fixture 1524 is opened, and because This fluid only from second fluid source 1506 advances to the supply chamber 1520 of suction lead 1502.In a third case, First fixture 1522 is open or partially open, and the second fixture 1524 is open or partially open, and therefore comes from first fluid source 1504 fluid and fluid from second fluid source 1506 advance to the supply chamber 1520 of suction lead 1502.In some cases Under, first fluid source 1504 may be at the temperature different from second fluid source 1506.In other cases, first fluid source 1504 may include and the different types of fluid in second fluid source 1506.In some embodiments, top high flow capacity Y adapter Group (B/Braun, Bethlehem, PA, USA) can be used for being couple to first fluid source 1504 and second fluid source 1506.

Figure 28 shows suction lead 900 comprising axis 901 with suction chamber 902 and has supply 904 (high pressure of chamber Chamber) supply pipe 903.Supply pipe 903 for example by adhesive, epoxy resin, be mechanically fixed or be thermally bonded or gluing is fixed To the inner wall 906 of axis 901.Supply chamber 904 is configured to carrying pressurized fluid 912, which may include salt water, dissolution (thrombolysis) agent, contrast agent or other medicaments.In use, pressurized fluid 912 is left with spray pattern 914 and supplies chamber 904 Distally 910 adjacent aperture 908, to impact the inner wall surface 916 of suction chamber 902.One or more medicaments can be undiluted Or can be diluted (for example, being diluted with salt water).Distal side point can be formed by hitting 911 to the jet stream injection of inner wall surface 916 Amount and/or nearside component, as being described in further detail in Figure 32, Figure 36 and Figure 40.Distal side component or nearside component can parts Ground fully substantially distad or is substantially oriented to nearside, this is individually because of such as following factor or these factors Any kind of combination: the specific positive pressure of the pressurized fluid 912 in supply chamber 904 is horizontal；Or because of the specific several of aperture 908 What shape；Or because the specific underpressure on suction chamber 902 is horizontal；Or the geometry in particular because of inner wall surface 916. Pump, syringe or other pressurized sources can be couple to the proximal end of supply chamber 904, to allow to supply the pressurization of chamber 904 or pulsation.One In a little embodiments, pump mount base 200 (Figure 12) can be used for supply chamber 904 of being supplied and pressurizeed with fluid 912.Supply pipe 903 includes Plug 918, the end of plug blocking supply chamber 904, to force pressurized fluid 912 to pass through aperture 908 and enter suction chamber 902, and when being operable for answering enough pressure against inner wall surface 916.

Spray pattern 914 can by aperture 908 relative to suction lead 900 longitudinal axis 917 vertically (that is, in 90 ° Angle) 914a guides towards inner wall surface 916, and/or can be with the oblique angle 914b that distad orients or the oblique angle oriented to nearside 914c hits inner wall surface 916.Spray pattern 914 can include two or three in these elements 914a, 914b, 914c simultaneously It is a.

The alternate embodiments of suction lead 915 are shown in Figure 29, and including 921 He of axis with suction chamber 922 Supply pipe 923 with supply chamber 924 (high pressure chest).Supply pipe 923 is fixed to the inner wall 926 of axis 921.Chamber 924 is supplied by structure Carrying pressurized fluid 912 is caused, which may include salt water, dissolution (thrombolysis) agent, contrast agent or other medicaments.It is a kind of Or various medicaments can be undiluted or can be diluted (for example, being diluted with salt water).Pressurized fluid 912 is with spray pattern 919 leave the aperture 928 adjacent with the supply distal end 920 of chamber 924, and impact the inner wall surface 909 of suction chamber 922.Inner wall table Face 909 includes add ons 929 (for example, deflecting element), which is configured for proximally or distally deflecting spray Penetrate at least part of pattern 919.Deflecting element 929 includes the forward direction inclined-plane 927 and back slope assembled at line of demarcation 931 925.Forward direction inclined-plane 927 is configured to distad deflect at least part of spray pattern 919, and back slope 925 is constructed At at least part to nearside deflection spray pattern 919.Hitting to the jet stream injection of inner wall surface 909 may include distal side component And/or nearside component, as being described in further detail in Figure 33 and Figure 37.In other embodiments, inner wall surface 909 can Be only inner wall 926 itself a part deformation.The deformation can replace deflecting element 929, and thus be used as deflection member Part 929.The deformation can be the angled of the distal end 907 of suction lead 900 or be formed, and inner wall 926 is made to have such as one A or multiple inclined-planes or angled or curved surface.

Distal side component or nearside component partly or wholly substantially distad or can be oriented substantially to nearside, this Individually because of any kind of combination of such as following factor or these factors: the spy of the pressurized fluid 912 in supply chamber 924 Determine positive pressure level；Or the geometry in particular because of aperture 928；Or because the specific underpressure on suction chamber 922 is horizontal；Or Geometry in particular of the person because of inner wall surface 909.Pump, syringe or other pressurized sources can be couple to the close of supply chamber 904 End, to allow to supply the pressurization of chamber 924 or pulsation.Supply pipe 923 includes plug 932, the distal end of plug blocking supply chamber 924 920, to force pressurized fluid 912 to pass through aperture 928 and enter suction chamber 922, and works as and be operable for answering enough pressure When against the inner wall surface 906 including inclined-plane 925,927.In some embodiments, to inclined-plane before the collision of spray pattern 919 927 a part distad deflects.In some embodiments, spray pattern 919 collision back slope 925 a part to Nearside deflection.In some embodiments, the negative pressure (for example, passing through vacuum source) for the specific quantity being applied on suction chamber 922 is controlled Spray pattern 919 processed impacts the degree on each inclined-plane 925,927.

In the suction lead 915 of Figure 29, the inclined-plane 925,927 of element 929 extends from line of demarcation 931 in a linear fashion, Wherein, effective inside radius of suction chamber linearly changes relative to the lengthwise position along inclined-plane 925,927.On the contrary, Figure 30 shows The suction lead 934 with the non-linear inclined-plane 942,944 (such as bending) extended between line of demarcation 933 is gone out.Sucking is led Pipe 934 includes the axis 935 with suction chamber 936 and the supply pipe 937 with supply chamber 938 (high pressure chest).Suction lead 934 is also Including the deflecting element 940 with inclined-plane 942,944, inclined-plane respectively includes recessed profile 946,948, so that suction chamber is effective Inside radius non-linearly changes relative to the lengthwise position along inclined-plane 942,944.In some embodiments, deflecting element 940 can be configured to for guiding and/or deflecting narrow and/or spray pattern 947 including jet stream (issuing from aperture 949). In other embodiments, the deflecting element 929 of the suction lead 915 of Figure 29 can be configured for guiding and/or deflect The spray pattern 919 of wider or obvious diverging or diffusion.

Figure 31 shows suction lead 950 comprising axis 951 with suction chamber 952 and has supply 954 (high pressure of chamber Chamber) supply pipe 953.Suction lead 950 further includes deflecting element 956, and the deflecting element is oblique with individually distad orienting Face 958, the inclined-plane are constructed such that at least part of the spray pattern 960 issued from aperture 962 in substantially distal direction Upper deflection.

Figure 32 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 900 of the Figure 28 inside used.Figure 32 shows the suction lead 900 in first operator scheme, is configured to Essence sucking thrombus 966.Venturi effect is generated by spray pattern 914, which may include jet stream.Therefore it is sucking Suction is generated at the distal openings 968 of chamber 902, and thrombus 966 is caused to be inhaled into suction chamber 902.Furthermore, it is possible to (for example, benefit With vacuum source, such as syringe, vacuum chamber or vacuum pump) in the proximal end of suction chamber 902 application suction pressure (negative pressure), thus protect It holds thrombus 966 and flows through suction chamber 902.The spray pattern 914 of pressurized fluid 912 impacts the opposite with aperture 908 of suction chamber 902 Thrombus 966 can also be macerated into smaller piece 970 by inner wall surface 916, this helps to reduce the combined-flow for flowing through suction chamber 902 The effective viscosity of body.By applying significant vacuum/suction pressure in the proximal end of suction chamber 902, can optimize to 966 He of thrombus The removal of any smaller portions 970 of thrombus 966.Spray pattern 914 impact in inner wall surface 916 after at least partly Turn into the stream 955 substantially oriented to nearside.

Figure 33 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 915 of the Figure 29 inside used.Figure 33 shows the suction lead 915 in first operator scheme, is configured to Essence is caused to suck thrombus 966.Venturi effect is generated by spray pattern 919, which may include jet stream.Therefore exist Suction is generated at the distal openings 972 of suction chamber 922, and thrombus 966 is caused to be inhaled into suction chamber 922.Furthermore, it is possible to (example Such as, vacuum source, such as syringe, vacuum chamber or vacuum pump are utilized) apply suction pressure (negative pressure) in the proximal end of suction chamber 922, Thus thrombus 966 is kept to flow through suction chamber 922.The 919 ballistic throw element 929 of spray pattern of pressurized fluid 912 and aperture 928 relative to back slope 925 can also by thrombus 966 be macerated at smaller piece 970, this facilitate reduce flows through suction chamber The effective viscosity of 902 compound fluid.By applying significant vacuum/suction pressure in the proximal end of suction chamber 922, can optimize Removal to any smaller portions 970 of thrombus 966 and thrombus 966.Spray pattern 919 is in impact in the anti-of deflecting element 929 At least partially pivot towards at the stream 957 substantially oriented to nearside after on inclined-plane 925.

Figure 34 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 934 of the Figure 30 inside used.Figure 34 shows the suction lead 934 in first operator scheme, is configured to Essence is caused to suck thrombus 966.Venturi effect is generated by spray pattern 947, which may include jet stream.Therefore, Suction is generated at the distal openings 974 of suction chamber 936, and thrombus 966 is caused to be inhaled into suction chamber 936.Furthermore, it is possible to (for example, using vacuum source, such as syringe, vacuum chamber or vacuum pump) (negative in the proximal end of suction chamber 936 application suction pressure Pressure), thus thrombus 966 is kept to flow through suction chamber 936.The 947 ballistic throw element 940 of spray pattern of pressurized fluid 912 with Aperture 949 relative to back slope 944 can also by thrombus 966 be macerated at smaller piece 970, this facilitate reduce flows through sucking The effective viscosity of the compound fluid of chamber 936.By applying significant vacuum/suction pressure, Ke Yiyou in the proximal end of suction chamber 936 Change the removal to any smaller portions 970 of thrombus 966 and thrombus 966.Spray pattern 947 is anti-ballistic throw element 940 At least partially pivot towards at the stream 959 substantially oriented to nearside after to inclined-plane 944.

Figure 35 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 950 of the Figure 31 inside used.Figure 35 shows the suction lead 950 in first operator scheme, is configured to Essence is caused to suck thrombus 966.Venturi effect is generated by spray pattern 960, which may include jet stream.Therefore, Suction is generated at the distal openings 976 of suction chamber 952, and thrombus 966 is caused to be inhaled into suction chamber 952.Furthermore, it is possible to (for example, using vacuum source, such as syringe, vacuum chamber or vacuum pump) (negative in the proximal end of suction chamber 952 application suction pressure Pressure), thus thrombus 966 is kept to flow through suction chamber 952.The spray pattern 960 of pressurized fluid 912 is impacted close to deflecting element 956 With aperture 962 relative to inner wall surface 978 can also by thrombus 966 be macerated at smaller piece 970, this facilitate reduce flows through The effective viscosity of the compound fluid of suction chamber 952.It, can by applying significant vacuum/suction pressure in the proximal end of suction chamber 952 To optimize the removal to any smaller portions 970 of thrombus 966 and thrombus 966.Spray pattern 960 is in impact close to deflection member The stream 961 substantially oriented to nearside is at least partly turned into after in the inner wall surface 978 of part 956.

Figure 36 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 900 of the Figure 28 inside used.Figure 36 shows the suction lead 900 in second operator scheme, is configured to Fluid (such as fluid comprising medicament) is distad sent out to the distal openings 968 of suction chamber 902.The spray of pressurized fluid 912 It penetrates pattern 914 and impacts inner wall surface 916 meeting opposite with aperture 908 of suction chamber 902 at least partly by 914 turns of spray pattern To at the stream 963 substantially distad oriented.In addition, can reduce, stop completely or simply not in the proximal end of suction chamber 902 Apply suction pressure (negative pressure), at least some spray patterns 914 is thus allowed to be transformed into after impact is in inner wall surface 916 The stream 963 substantially distad oriented.In some embodiments, aperture 908 and/or inner wall surface 916 can be configured to So that in some cases, the stream 963 substantially distad oriented can be jet stream in itself.The medicament may include lytic agent, Such as thrombolytics, or may include contrast agent.The stream 963 substantially distad oriented may include 50% or more injection scheme Case 914 (in deflection) perhaps 60% or more perhaps 70% or more perhaps 80% or more or 90% or more, Or even 100%.

Figure 37 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 915 of the Figure 29 inside used.Figure 37 shows the suction lead 915 in second operator scheme, is configured to Fluid (such as fluid comprising medicament) is distad sent out to the distal openings 972 of suction chamber 922.The spray of pressurized fluid 912 The forward direction inclined-plane 927 opposite with aperture 928 for penetrating 919 ballistic throw element 929 of pattern can be at least partly by spray pattern 919 Turn into the stream 965 substantially distad oriented.In addition, can reduce, stop completely or simply not in the close of suction chamber 922 End applies suction pressure (negative pressure), thus allows at least some spray patterns 919 in impact on the forward direction inclined-plane of deflecting element 929 It is transformed into the stream 965 substantially distad oriented after on 927.In some embodiments, the aperture 928 of deflecting element 929 And/or forward direction inclined-plane 927 can be constructed such that the stream 965 itself that in some cases, substantially distad orients can be with It is jet stream.The medicament may include lytic agent, such as thrombolytics, or may include contrast agent.

Figure 38 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 934 of the Figure 30 inside used.Figure 38 shows the suction lead 934 in second operator scheme, is configured to Fluid (such as fluid comprising medicament) is distad sent out to the distal openings 974 of suction chamber 936.The spray of pressurized fluid 912 The forward direction inclined-plane 942 opposite with aperture 949 for penetrating 947 ballistic throw element 940 of pattern can be at least partly by spray pattern 947 Turn into the stream 967 substantially distad oriented.In addition, can reduce, stop completely or simply not in the close of suction chamber 936 End applies suction pressure (negative pressure), thus allows at least some spray patterns 947 in impact on the forward direction inclined-plane of deflecting element 940 It is transformed into the stream 967 substantially distad oriented after on 942.In some embodiments, the aperture 949 of deflecting element 940 And/or forward direction inclined-plane 942 can be constructed such that the stream 967 itself that in some cases, substantially distad orients can be with It is jet stream.The medicament may include lytic agent, such as thrombolytics, or may include contrast agent.

Figure 39 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 950 of the Figure 31 inside used.Figure 39 shows the suction lead 950 in second operator scheme, is configured to Fluid (such as fluid comprising medicament) is distad sent out to the distal openings 976 of suction chamber 952.The spray of pressurized fluid 912 The inclined-plane 958 that distad orients opposite with aperture 962 for penetrating 960 ballistic throw element 956 of pattern will can at least partly spray Pattern 960 is penetrated to turn into the stream 969 substantially distad oriented.In addition, can reduce, stop completely or do not sucking simply The proximal end of chamber 952 applies suction pressure (negative pressure), thus allows at least some spray patterns 960 in ballistic throw element 956 It is transformed into the stream 969 substantially distad oriented after the inclined-plane 958 distad oriented.In some embodiments, deflection member The aperture 962 of part 956 and/or the inclined-plane 958 distad oriented can be constructed such that in some cases, substantially to remote The stream 969 of side positioning can be jet stream in itself.The medicament may include lytic agent, such as thrombolytics, or may include radiography Agent.

Using can to the relevant second operator scheme of suction lead 900,915,934,950 described in Figure 36 to Figure 39 So that the correct exact way of dosage realizes the transmission of the medicament comprising drug, without wasting usually expensive drug. The small internal diameter for supplying the transversely inner size of chamber 904,924,938,954 introduces medicament with not only allowing for accurate and small size, and And also avoid undesirable medicament loss when it is desirable that stopping injection suddenly.This is to feed injecting systems to normal gravity Significant improvement.In addition, additionally being increased to the supply pressurization of chamber 904,924,938,954 with transmitting medicament using pump mount base 200 (Figure 12) Precision, control are added and have not wasted.It reduce the cost of surgical procedure, drug therapy (such as contrast agent is improved Transmission) accuracy, and may also speed up surgical procedure, since it is desired that the mistake corrected is less, or need duplicate step It is rapid less.This itself may be another factor of save the cost.Although defined using " sucking " word suction chamber 902, 922,936,952 and suction lead 900,915,934,950, it will be understood that user can choose only in the second mould Suction lead 900,915,934,950 is used under formula, can choose as described in about Figure 36 to Figure 39, and in some cases It is done so in the case where no any sucking.

Figure 40 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 900 of the Figure 28 inside used.Figure 40 shows the suction lead 900 in third operation mode, is configured to Fluid (such as fluid comprising medicament) is distad sent out into the distal openings 968 of suction chamber 902, while also causing thrombus 966 at least some suckings.The spray pattern 914 of pressurized fluid 912 impacts the inner wall opposite with aperture 908 of suction chamber 902 Spray pattern 914 can be at least partly divided into the stream 963 substantially distad oriented and substantially oriented to nearside by surface 916 Stream 955.It can apply in the proximal end of suction chamber 902, adjust, increased or decrease suction pressure (negative pressure), thus allow at least Some spray patterns 914 are transformed into the stream 963 substantially distad oriented after impact is in inner wall surface 916, and extremely Few some spray patterns 914 are transformed into the stream 955 substantially oriented to nearside after impact is in inner wall surface 916.One In a little embodiments, aperture 908 and/or inner wall surface 916 be can be constructed such that in some cases, substantially distad The stream 963 of orientation can be jet stream in itself.The medicament may include lytic agent, such as thrombolytics, or may include contrast agent.

Figure 41 is shown as intake system 10 or a part of the system 100,800 for sucking thrombus is in blood vessel 964 The suction lead 934 of the Figure 30 inside used.Figure 41 shows the suction lead 934 in third operation mode, is configured to Fluid (such as fluid comprising medicament) is distad sent out into the distal openings 974 of suction chamber 936, while also causing thrombus 966 at least some suckings.The 947 ballistic throw element 940 of spray pattern of pressurized fluid 912 it is opposite with aperture 949 oblique Spray pattern 947 can be at least partly divided into the stream 967 substantially distad oriented and substantially determined to nearside by face 942,944 To stream 959.Can apply in the proximal end of suction chamber 936, adjust, increased or decrease suction pressure (negative pressure), thus allow to Few some spray patterns 947 are transformed into after impact is on the forward direction inclined-plane 942 of deflecting element 940 substantially distad to be oriented Stream 967, and at least some spray patterns 947 are transformed into base after impact is on the back slope 944 of deflecting element 940 The stream 959 oriented in sheet to nearside.In some embodiments, the aperture 949 and/or forward direction inclined-plane 942 of deflecting element 940 can To be constructed such that the stream 967 in some cases, substantially distad oriented can be jet stream in itself.The medicament can wrap Lytic agent, such as thrombolytics are included, or may include contrast agent.

Figure 42 shows suction lead 1000 comprising axis 1001 with suction chamber 1002 has the first supply chamber 1004 first supply pipe 1003 and the second supply pipe 1005 for supplying chamber 1006 with second.First supply pipe 1003 and second Supply pipe 1005 is fixed to the inner wall 1008 of axis 1001.First supply chamber 1004 is configured to carrying pressurized fluid 912, the pressurization Fluid may include salt water, dissolution (thrombolysis) agent, contrast agent or other medicaments.Pressurized fluid 912 is left with spray pattern 1014 First aperture 1010 of the first supply chamber 1004, the spray pattern is relative to the longitudinal axis 1018 of suction lead 1000 to tilt The angle 1016 that distad orients be oriented to.Second supply chamber 1005 is configured to carrying pressurized fluid 912, which can To include salt water, dissolution (thrombolysis) agent, contrast agent or other medicaments.Pressurized fluid 912 leaves the second confession with spray pattern 1022 Answer the second aperture 1020 of chamber 1006, the spray pattern relative to suction lead 1000 longitudinal axis 1018 with inclined to close The angle 1024 of side positioning is oriented to.One or more medicaments can be undiluted or can be diluted (for example, dilute with salt water It releases).

First bending hollow tip extensions 1026 supply its in chamber 1004 the first of insertion first supply pipe 1003 It include overall diameter at proximal end 1012.The bending alignment of the first bending hollow tip extensions 1026 is distad oriented with inclined Angle 1016 leaves the spray pattern 1014 in the first aperture 1010, so that the stream 1028 substantially distad oriented is directed to or determines To except the open distal end 1030 of suction chamber 1002.Second bending hollow tip extensions 1032 are in insertion second supply pipe It include overall diameter at its proximal end 1034 in 1005 the second supply chamber 1006.Second bending hollow tip extensions 1032 it is curved Song alignment leaves the spray pattern 1022 in the second aperture 1020 with the inclined angle 1024 oriented to nearside so that substantially to The inner wall surface 1040 of the stream 1038 of nearside orientation towards suction chamber 1002 orients.Apply and adjust in the proximal end of suction chamber 1002 Negative pressure can be used for adjusting the degree of sucking (for example, thrombus or blood) and distad transmit medicament by the first aperture 1010 Degree.

Figure 43 shows suction lead 1050 comprising axis 1051 with suction chamber 1052 and has the first supply chamber 1054 first supply pipe 1053.First supply pipe 1053 is branched into the first tubular branch 1046 with first branch's chamber 1047 With the second tubular branch 1048 with second branch's chamber 1049.First tubular branch 1046 and the second tubular branch 1048 are fixed To the inner wall 1056 of axis 1051.First supply chamber 1054, the first tubular branch 1046 and the second tubular branch 1048 are configured to Pressurized fluid 912 is carried, which may include salt water, dissolution (thrombolysis) agent, contrast agent or other medicaments.Pressurized fluid 912 leave the first aperture 1058 of the first tube chamber 1047 with spray pattern 1060, and the spray pattern is relative to suction lead 1050 longitudinal axis 1064 is oriented to the inclined angle 1062 distad oriented.Pressurized fluid 912 is with spray pattern 1068 Leave the second aperture 1066 of second branch's chamber 1049, the spray pattern relative to suction lead 1050 longitudinal axis 1064 with The inclined angle 1070 oriented to nearside is oriented to.One or more medicaments can be undiluted or can be diluted (example Such as, it is diluted with salt water).With one or more inclined-planes 1074,1076 (for example, forward direction inclined-plane 1074 and back slope 1076) One or more deflecting members 1072 can be carried on the inner wall 1078 of suction chamber 1052, for deflecting one or two Spray pattern 1060,1068, with the stream 1082 for generating the stream 1080 distad oriented and/or being oriented to nearside.In other implementations In mode, forward direction inclined-plane 1074 and/or back slope 1076 can be simply the protruding portion of inner wall 1078, or can be by axis 1001 deflection is formed.

Figure 44 A shows the conduit 1200 with axis 1202 and supply pipe 1204, which has chamber 1203, supply pipe tool There is supply chamber 1206.Supply pipe 1204 is fixed to the inner wall 1208 of axis 1202, and including aperture 1210, which is configured to use It is left in guidance pressurized fluid with spray pattern 1212, which can form jet stream.Spray pattern 1212 is directed toward relatively Deflecting member 1214, which can be the separate part on the inner wall 1208 fixed to axis 1202, or It can be the shaped portion of axis 1202.Chamber 1204 is guidewire lumen, is configured to allow for conduit 1200 on seal wire (not shown) It is tracked.When in use, conduit 1200 is operated as injection catheter, and seal wire can be retracted to 1210 He of aperture to nearside Deflecting member 1214 allows them to work and potential interference is less.In some cases, seal wire can be moved completely It removes.In other embodiments, chamber 1204 can be suction chamber, be configured for sucking such as thrombus or other embolisms Material.Chamber alternatively has other purposes, such as the conduit injected or be transfused for more volume.Deflecting member 1214 With the flat surfaces laterally or radially extended, and it is configured to deflection spray pattern 1212.For example, deflecting member 1214 can It is configured to deflection spray pattern 1212, so that at least some medicaments for having spray pattern 1212 to carry are pushed out the remote of chamber 1204 Side opening 1215.

Figure 44 B shows conduit 1216 comprising the axis 1218 with chamber 1220 and the supply pipe with supply chamber 1224 1222.Supply pipe 1222 is fixed to the inner wall 1226 of axis 1218, and including aperture 1228, which is configured for guidance and adds Pressure fluid is left with spray pattern 1230, which can form jet stream.Spray pattern 1230 is directed toward opposite deflection structure Part 1232, which can be the separate part on the inner wall 1226 fixed to axis 1218, or can be axis 1218 shaped portion.As the chamber 1203 of the conduit 1200 of Figure 44 A, chamber 1220 can be guidewire lumen and/or suction chamber, or Person can have other purposes.Deflecting member 1232 has the flat surfaces longitudinally or axially extended, and is constructed such that spray Penetrate the deflection of pattern 1230.For example, deflecting member 1232 can be configured to deflect spray pattern 1230, so that spray pattern 1230 At least some distal openings 1234 for being pushed out chamber 1220 of the medicament of carrying.

Figure 45 A shows the conduit 1236 with axis 1238 and supply pipe 1242, which has chamber 1240, supply pipe tool There is supply chamber 1244.Supply pipe 1242 is fixed on the inner wall 1246 of axis 1238, and including aperture 1248, which is configured to For guiding pressurized fluid to leave with spray pattern 1250, which can form jet stream.Spray pattern 1250 is directed toward phase Pair deflecting member 1252, which can be the separate part on the inner wall 1246 fixed to axis 1238, or can be with It is the shaped portion of axis 1238.Chamber 1240 is guidewire lumen, and conduit 1236 is configured to allow for carry out on seal wire (not shown) Tracking.In use, conduit 1236 is operated as injection catheter, and seal wire can be retracted to aperture 1248 and deflection to nearside Component 1252 allows them to work and potential interference is less.In some cases, seal wire can be completely removed.? In other embodiments, chamber 1240 can be suction chamber, be configured for the material of sucking such as thrombus or other embolisms. Chamber alternatively has other purposes, such as the conduit injected or be transfused for more volume.When from end-view, Deflecting member 1252 has convex surface, and is constructed such that spray pattern 1250 deflects.For example, deflecting member 1252 can be constructed At spray pattern 1250 is deflected, so that at least some distal sides for being pushed out chamber 1240 for the medicament that spray pattern 1250 carries are opened Mouth 1254.

Figure 45 B shows conduit 1256 comprising the axis 1258 with chamber 1260 and the supply pipe with supply chamber 1264 1262.Supply pipe 1262 is fixed to the inner wall 1266 of axis 1258, and including aperture 1268, which is configured for guidance and adds Pressure fluid is left with spray pattern 1270, which can form jet stream.Spray pattern 1270 is directed toward opposite deflection structure Part 1272, which can be the separate part on the inner wall 1266 fixed to axis 1258, or can be axis 1258 shaped portion.Chamber 1260 can be guidewire lumen and/or suction chamber, or can have other purposes.It is seen when from side When examining, deflecting member 1272 has convex surface, and is constructed such that spray pattern 1270 deflects.For example, deflecting member 1272 can It is constructed such that spray pattern 1270 deflects, so that at least some chambers 1260 of being pushed out for the medicament that spray pattern 1270 carries Distal openings 1274.

Figure 63 shows conduit 1656 comprising the axis 1658 with chamber 1660 and the supply pipe with supply chamber 1664 1662.Supply pipe 1662 is fixed to the inner wall 1666 of axis 1658, and including aperture 1668, which is configured for guidance and adds Pressure fluid is left with spray pattern 1670, which can form jet stream.Spray pattern 1670 is directed toward opposite deflection structure Part 1672, which can be the separate part on the inner wall 1666 fixed to axis 1658, or can be axis 1658 Shaped portion.Chamber 1660 can be guidewire lumen and/or suction chamber, or can have other purposes.When viewed from the side, partially Turn component 1672 with inclined surface, and be configured to substantially distad deflect spray pattern 1670, so that spray pattern It is pushed out the distal openings 1674 of chamber 1660.Deflecting member 1672 may include when being formed as individual component metal parts or Polymer elements.

Figure 64 shows conduit 1756 comprising the axis 1658 with chamber 1760 and the supply pipe with supply chamber 1764 1762.Supply pipe 1762 is fixed to the inner wall 1766 of axis 1758, and including aperture 1768, which is configured for guidance and adds Pressure fluid is left with spray pattern 1770, which can form jet stream.Spray pattern 1770 is directed toward opposite deflection structure Part 1772, which can be the separate part on the inner wall 1766 fixed to axis 1758, or can be axis 1758 Shaped portion.Chamber 1760 can be guidewire lumen and/or suction chamber, or can have other purposes.When viewed from the side, partially Turn component 1772 with inclined surface, and is configured to substantially deflect spray pattern 1770 to nearside.Deflecting member 1772 It may include metal parts or polymer elements when being formed as individual component.

Figure 46 A and Figure 46 B show the conduit 1276 with axis 1278 and supply pipe 1282, which has chamber 1280, should Supply pipe has supply chamber 1284.Supply pipe 1282 is fixed to the inner wall 1286 of axis 1278, and including aperture 1288, the aperture quilt It is configured to for guiding pressurized fluid to leave with spray pattern 1290, which can form jet stream.Spray pattern 1290 It is directed toward the opposite adjustable deflection component 1292 at least two states, two states are respectively first state (Figure 46 A) With the second state (Figure 46 B).In the embodiment shown, adjustable deflection component 1292 includes air bag, which is fixed to The inner wall 1286 of axis 1278 makes it possible to and inflates or put via fluid passage 1294 that is in axis 1278 or being carried by axis 1278 Gas.Air charging system with or without volume measurement device, pressure sensor and/or pressure gauge can be couple to fluid passage 1294 proximal end, to facilitate the inflated for deflated of air bag.Chamber 1280 is guidewire lumen, and conduit 1276 is configured to allow for exist The enterprising line trace of seal wire (not shown).In use, conduit 1276 is operated as injection catheter, and seal wire can be withdrawn to nearside To aperture 1288 and adjustable deflection component 1292, allows them to work and potential interference is less.In some cases, Seal wire can be completely removed.In other embodiments, chamber 1280 can be suction chamber, be configured for suction such as The material of thrombus or other embolisms.Chamber alternatively has other purposes, such as injecting or be transfused for more volume Conduit.

Adjustable deflection component 1292 is constructed such that injection under at least one of its two or more state state Pattern 1290 deflects.For example, adjustable deflection component 1292 can be configured to deflect spray pattern 1290, so that by injection scheme At least some distal openings 1296 for being pushed out chamber 1280 for the medicament that case 1290 carries.In the first state shown in Figure 46 A, Adjustable deflection component 1292 is deflated, or, in other words, internal capacity 1298 is substantially empty.For example, if making Conduit 1276 passes through on the seal wire for extending through chamber 1280, or (seal wire is in place or not if transit chamber 1280 is sucked In place), then first state may be needed.In another form of first state, vacuum (negative pressure) can be additionally provided in simultaneously (for example, evacuation syringe or evacuation locking syringe from 1294 proximal end of fluid passage) is maintained on fluid passage 1294, with Make the contouring minimization for the adjustable deflection component 1292 deflated, to keep the cross-sectional area of the chamber 1280 in the region maximum Change.In the second state shown in Figure 46 B, fluid be injected by fluid passage 1294 (for example, by syringe or other The air charging system of type), and adjustable deflection is entered by the hole 1299 between fluid passage 1294 and internal capacity 1298 In the internal capacity 1298 of component 1292.Adjustable deflection component 1292 in its second state is constructed such that spray pattern 1290 deflect in a desired direction, for example, at least outside partially by the distal openings 1296 of chamber 1280.That inflates is adjustable The shape of section deflecting member 1292 is portrayed as raised property in Figure 46 B, but in other embodiments, composition can The air bag or other structures for adjusting deflecting member 1292 can be manufactured into form one or more linear slopes or other shapes. In addition, by the way that adjustable deflection component 1292 is adjusted to several different states, by the fluid injection by different volumes Several different shape or size may be implemented in portion's volume 1298.During manufacture, the shape of adjustable deflection component 1292 can To carry out hot forming by using one or more molds or fixed device.Additional state is also possible, wherein adjustable inclined Turn component 1292 and be inflated to be enough substantially or entirely to block chamber 1280, or partially or completely blocks aperture 1288.For example, In the case that embolus is inhaled into conduit, this additional state may be desired, and it is expected to lead from patient's removal Embolus is firmly held in conduit 1276 while pipe 1276.

Figure 47 is shown with chamber 1302, wall 1304 and across the supply pipe 1300 in the aperture of wall 1,304 1306.From chamber The spray pattern 1308 for leaving aperture 1306 that pressurized fluid in 1302 issues has substantially solid or straight stream, In, width (or diameter) W of stream is not dramatically increased.Figure 48 is shown with chamber 1312, wall 1314 and across the hole of wall 1314 The supply pipe 1310 of mouth 1316.The spray pattern 1318 for leaving aperture 1316 issued from the pressurized fluid in chamber 1312 has folder Angle is the divergent flow of x.Figure 49 shows the three-dimensional depiction of the spray pattern 1320 with divergent flow, therefore this gives injection scheme 1320 cone shape 1322 of case.

Figure 50 is shown with chamber 1326, wall 1328 and across the supply pipe 1324 in the aperture of wall 1,328 1330.From chamber It is the stream of hollow conic 1334 that the spray pattern 1332 for leaving aperture 1330 that pressurized fluid in 1326 issues, which has shape,. Figure 51 shows the supply pipe 1336 with chamber 1338, wall 1340 and the rectangular apertures 1342 across wall 1340.Out of chamber 1338 Pressurized fluid issue the spray pattern 1344 for leaving rectangular apertures 1342 have diverging wedge shape 1346 stream.

Figure 52 is shown with chamber 1350, wall 1352 and across the supply pipe 1348 in the aperture of wall 1,352 1354.From chamber The spray pattern 1356 for leaving aperture 1354 that pressurized fluid in 1350 issues have the axis AO relative to aperture 1354 at The direction vector V of angle y.The central part of direction vector expression spray pattern 1356.Spray pattern 1356 dissipates and has Angle x.Spray pattern has farthest end 1355 and nearest end 1357.The axis AO shape of farthest end 1355 and aperture 1354 Angled Z_D, and end 1357 and the axis AO in aperture 1354 form angle Z recently_P.In other embodiments, spray pattern 1356 can have the shape similar to any one of the spray pattern 1308,1318,1320,1332,1344 of Figure 47 to Figure 51 Shape or any other shape.

Any shape of spray pattern 1308,1318,1320,1332,1344,1356 can supply tube wall by modification In the structure (lateral dimension, diameter, length or wall thickness, angle, cone angle, cross-sectional shape) in aperture customize, this facilitates Spray pattern and inner wall surface 916,1040,1078 or deflecting element/component 929,940,956,1072,1214,1232, 1252,1272,1292 docking, to generate many different manifold shapes, including the stream that substantially distad orients and/or to nearside The stream of orientation.Spray pattern 1308,1318,1320,1332,1344,1356 can be customized to include jet stream, stream, mist or other Spray physical characteristic.By means of changing the pressure of pressurized fluid, spray pattern 1308,1318,1320,1332,1344,1356 can To be converted between any one of these different modes or shape.

Figure 53 shows suction lead 1360, which is already inserted into blood vessel 1362 (artery, vein etc.) and pushes away Into so that the open distal end 1364 of suction chamber 1366 is adjacent to thrombus/grumeleuse 1368.Suction lead 1360 further includes having to supply The supply pipe 1370 of chamber 1372, and the guiding tube 1374 with guidewire lumen 1376 are answered, is configured to enterprising in seal wire 1378 Line trace.Diluted or non-diluted contrast agent is pressurized by syringe, pump or other devices by supplying chamber 1372, so that its Aperture 1380 is left in the distal end 1382 of supply chamber 1372.Jet stream injection 1384 may include distal side component and/or nearside component.Far Side component 1386 (Figure 54) can be the component substantially distad oriented, and can at least partly leave suction chamber 1366 Open distal end 1364.When distal side component 1386 fill thrombus/grumeleuse 1368 around volume when (Figure 54), can be in ray Photograph or the lower observation of the fluoroscopy distal side component, to identify the boundary 1388 of thrombus/grumeleuse 1368.If boundary 1388 Desired in recency positioned at the open distal end 1364 of the suction chamber 1366 of suction lead 1360, then user may want to make With high pressure by the injection of supply chamber 1372 or pumping (for example, with syringe or pump), to start or continue to thrombolysis surgical procedure.? Under some cases, dilution or non-diluted contrast agent is can be used to execute thrombolysis surgical procedure in user.In some cases, dilute It releases or non-diluted contrast agent can be combined or be mixed with lytic agent.In other cases, user can use salt water or lytic agent Replacement dilution or non-diluted contrast agent, such as chamber is supplied by perfusion.On the contrary, being led if boundary 1388 is located remotely from sucking The open distal end 1364 of the suction chamber 1366 of pipe 1360 is more than desired amount, then user can choose propulsion suction lead 1360, until open distal end 1364, the expectation on the boundary of thrombus/grumeleuse 1,368 1388 is leaned in recency.In some cases, It is desired to can be by recency when open distal end 1364 is flushed with the boundary 1388 of thrombus/grumeleuse 1368.In some feelings It is desired to can be in open distal end 1364 and the boundary 1388 of thrombus/grumeleuse 1368 by recency at a distance of about 1mm under condition When.In some cases, desired to can be by recency on the boundary 1388 of open distal end 1364 and thrombus/grumeleuse 1368 When at a distance of about 5mm.Once user promotes suction lead 1360, so that open distal end 1364 is on the side of thrombus/grumeleuse 1368 In recency, user can start or continue to thrombolysis surgical procedure for the expectation on boundary 1688.

Figure 55 shows a kind of method, wherein user is continuous or Extemporaneous injection or " ejections " (or the institute of contrast agent 1396 on a small quantity State radiography agent composition), continuously to depict the boundary 1388 of thrombus/grumeleuse 1368 and the suction chamber of suction lead 1360 Recency is leaned in 1366 open distal end 1364.In any embodiment given herein, the distal end of suction lead 1360 1390 may include radiopaque label or label band 1392.In some embodiments, duct conduits 1394 can be not The pipeline of radioparent, including radiopaque material, including but not limited to barium sulfate, tantalum oxide or titanium oxide.

Figure 56 shows conduit system 1400 comprising has the conduit 1402 of supply chamber 1404 and chamber 1406.Around confession The wall 1410 for answering chamber 1404 includes aperture 1408.Mandrel 1412 with proximal end 1414 and distal end 1416 extends through chamber 1406. Distally 1416 can have bending part 1418 (or hook portion), which includes engaging for the wall 1422 with conduit 1402 Recess 1420.Mandrel 1412 can be configured to be inserted through chamber 1406, so that 1420 joined wall in the following manner of recess 1422 distal end 1424 (for example, at open distal end 1426): user can apply in mandrel 1412 tractive force (arrow, Figure 57), to pull the distal end 1428 of conduit 1402 along proximal direction.As shown in figure 57, the tractive force combination conduit 1402 Column intensity causes the distal end 1428 of conduit 1402 to bend.In some cases, deflection can be by being applied to mandrel 1412 Certain force on proximal end 1414 controls (for example, by hand or by being connected to grabbing for proximal end 1414 by collet or other locks Take tool) so that the fluid jet 1430 for leaving aperture 1408 turn at make its impact in adjacent structure (such as thrombus/grumeleuse 1432) on.In some embodiments, according to other embodiments described herein, chamber 1406 may be used as suction chamber, and It can be also used for sucking at least some thrombus 1432.In this embodiment, mandrel 1412 can also be used in thrombus 1432 via Vacuum is detached from chamber 1406 and thrombus 1432 in the case where engaging with the open distal end 1426 of chamber 1406.Contrast agent can be added It is added to and is passing through in the fluid that supply chamber 1404 transmits, preferably to observe position and the state of thrombus 1432.Such as fruit caving 1406 not operatively for sucking, then contrast agent can even be transmitted through chamber 1406.User can make the remote of conduit 1402 End 1428 is bent to and fro, so that fluid jet 1430 destroys each region/area of thrombus 1432.In addition, user is to chamber 1406 Apply vacuum to remove rupture/maceration thrombus from blood vessel 1362.Therefore, more thoroughly and thrombus 1432 can be effectively removed.

Figure 58 shows conduit system 1434, most of feature of the conduit system 1400 with Figure 56 and Figure 57, but With additional preforming shape.Mandrel 1436 is constructed such that the distal end 1438 of conduit 1440 is bent, but conduit 1440 is remote In addition end 1438 has preformed bending 1442.Therefore, big bending angle F range is possible, to allow jet stream 1444 Itself is with many different possibility track collision thrombus.Figure 62 shows conduit system 1530, by the conduit system of Figure 58 1434 controlled deflection is combined with the interior deflector of jet stream.Conduit 1532 includes chamber 1534, the supply with supply chamber 1538 Pipe 1536 and tension mandrel 1540.The distal end 1542 of supply chamber 1538 terminates at aperture 1544.The first deflected (on Face) in, jet stream 1546 is deflected from 1: 1548 on inner wall 1550, and in the stream 1552 substantially distad oriented first Deflection.The second deflected (below) in, jet stream 1554 is deflected from the second point 1556 on inner wall 1550, and basic second On deflect in the stream 1558 that distad orients.Because the first stream 1552 substantially distad oriented and second is substantially distad The stream 1558 of orientation is with different vector orienteds, so can make distal side jet stream by the controlled tractive effort in tension mandrel 1540 Or stream turns to.Therefore, for the conduit system 1530 of the conduit system of Figure 58 1434 and Figure 62, allow to lead by different Pipe mechanism turns to the stream distad oriented or jet stream.

Figure 59 A and Figure 59 B show intake system 1450 comprising have supply chamber 1454, suction chamber 1456 and supplying The suction lead 1452 in the aperture 1458 being connected between chamber 1454 and suction chamber 1456 is answered, and there is proximal end 1462 and distal end 1464 mandrel 1460, distal end 1464 include enlarged 1466.The enlarged 1466 of mandrel 1460 may include hook (for example, Shepherd battle), bending or other structures, when making mandrel 1460 (and therefore, enlarged 1466) rotation 1470 and/or longitudinal translation When 1472, the hook, bending or other structures can effectively destroy thrombus 1468.Mandrel 1460 is inserted through suction lead 1452 suction chamber 1456, and can be rotated and the proximal end 1462 of mandrel 1460 is attached to rotating device 1474.Rotation Rotary device 1474 can also be such that mandrel 1460 longitudinally translates back and forth.Rotating device 1474 may include such device, such as The SPINR sold by the value medical company of Utah, USA south Jordan^TMDevice or Vesatek by California, USA Irving city The FireBow that Co., Ltd sells^TMDevice.Enlarged 1466 can be used for by via rotation and/or the longitudinal position of circulation It moves and applies destructive power to destroy the fiber and/or calcification cap 1476 at 1468 one end of thrombus.The convex of enlarged 1466 is blunt Shape part 1478 can form the hurtless measure end of mandrel 1460.Rotating device 1474 includes handle 1480, motor 1482, rotatable Chuck or lock 1484 and transmission device 1486, the transmission device are configured to the movement from motor being coupled to rotatable card The movement (for example, rotation and/or longitudinal translation) of disk or lock 1484.In some embodiments, transmission device 1486 can wrap Include gear.When user holds handle 1480, user can be with push switch 1488, to start or stop rotation/movement.Some In embodiment, mandrel 1460 can also be used in a manner of the mandrel 1412 of Figure 56 and Figure 57 or the mandrel 1436 of Figure 58.

Figure 60 is shown for removing Intracranial thrombus or intracranial hematoma by window, hole or the hole on patient's cranium The system of (being simply shown as BC blood clot).Window, hole or hole can be produced by any suitable device, including but not limited to Hand drill with burr or other cutting elements.Referring to Figure 60, trochar 1156 (such as four-way trochar) can be by leaning on The introducer 1100 for the treatment of region where nearby bleeding grumeleuse BC introduces.Visualization device 1158 (such as endoscope apparatus, including but It is not limited to the NeuroPen of Medtronic Inc. or Epic of the graceful J&J company of Coudé of New Jersey Piscataway city Microvision it) can be introduced into the visualization channel of trochar 1156, and Vltrasonic device 1112 can be introduced into casing In the service aisle of needle 1156.Vltrasonic device 1112 can emit under the frequency for example between about 1kHz to about 20MHz, And it can be configured to destroy or decompose blood clot BC.

Figure 60 shows the cross-sectional view of human skull and brain, and it illustrates the introducings that the hole passed through in skull is placed Device 1100.Trocar Assembly 1156 passes through introducer 1100 and places and in the treatment region that is located in where blood clot BC.Brain Middle artery MCA is also shown as.In general, trochar 1156 can be introduced directly into skull in the case where not using introducer 1100 In hole in.Visualization device 1158 can be introduced by the visualization channel of trochar 1156.Visualization device 1158 is logical It crosses cable 1159 and is connected to monitor (not shown).Some visualization devices (such as endoscope) have can be used for visualize rather than The vision element of monitor.Vltrasonic device 1112 with handle 1157 is introduced by the service aisle of trochar 1156.? Before surgical procedure, the trochar 1156 of 1158 lower section of visualization device is directed to the position of blood clot BC by doctor, then will The distal end of Vltrasonic device 1112 is located in inside blood clot and ultrasonic energy is activated to transmit.When therapeutic device 1112 dissolves and sucks When blood clot from patients head, doctor can observe treatment region with visualization device 1158 simultaneously.Blood clot can pass through It rinses or overflow ducts is inhaled into, the flushing or overflow ducts are similar to the suction chamber of suction lead described herein.In addition, blood Grumeleuse can be inhaled by Vltrasonic device 1112.Nita is entitled " for from patient's head what is announced on December 27th, 2012 Method and apparatus (the Method and Apparatus for Removing Blood Clots of portion's removal blood clot and tissue And Tissue from the Patient ' s Head) " U.S. Patent Application Publication No. 2012/0330196 in describe For removing the appropriate system of Intracranial thrombus or intracranial hematoma.

In order to further increase the ability of dissolved blood clot BC, by one or more pharmaceutical preparations or microvesicle or nano bubble Being transmitted to blood clot position may be helpful.This pharmaceutical preparation, microvesicle or nanometer bubble can directly or with conventional salt Water is mixedly transmitted to treatment position.

Brain temperature is considered as a key factor of ischemic brain damage.Clinical evidence shows that low temperature can improve brain Damage.In addition, the therapeutic cooling (whole body is cooling) between 30 DEG C or 35 DEG C including patients head or whole body can be reduced Ischemic brain damage reduces intracranial pressure and edema following intracerebral hemorrhage.Ice is placed around head or neck with a kind of simple method Block or epoxy resin packet may be implemented to concentrate skull cooling.Whole body cooling can inject ice by using intravenous injection (IV) method Cold salt water is completed.

Any embodiment described herein can be with Penumbra Inc. of California, USA Alameda city Apollo^TMSystem is used in combination.

In some cases, part or all in apparatus described herein can doped with, be formed with, be coated with or It in other ways include radiopaque material.Radiopaque material is considered as can be during medical procedure The material of relatively bright image or another imaging technique is generated on fluorescopy screen.Some examples of radiopaque material It may include but be not limited to gold, platinum, palladium, tantalum, tungsten alloy, the polymer material for being mounted with radiopaque filler etc..It can be used One or more hydrophilic or hydrophobic lubricant coatings, to improve trace ability of the suction lead 118 by blood vessel (trackability)。

In some cases, a degree of MRI compatibility can be imparted into some parts of apparatus described herein In.For example, in order to enhance and the compatibility of magnetic resonance imaging (MRI) machine, it would be desirable to by not making MRI image substantially Distortion does not cause the material of apparent artifact (artifacts) (gap in image) to manufacture each of apparatus described herein A part.Some ferrimagnets are for instance it can be possible that unsuitable, because they may generate artifact in MRI image.One In a little situations, apparatus described herein may include the imageable material of MRI machine.Some materials that these characteristics are presented include Such as tungsten, cobalt-chromium-molybdenum alloy are (for example, UNS:R30003, such asDeng), nickel-cobalt- Chromium-molybdenum alloy (for example, UNS:R30035, such asDeng), Nitinol etc. and other materials.

In some cases, some in apparatus described herein may include coating, such as lubricant coating or hydrophilic painting Layer.Such as fluoropolymer-containing hydrophobic coating provides dry lubricity.Lubricant coating improves navigability, and improves Lesion ride-through capability.Suitable lubricious polymeric object is well known in the art, and may include silicone etc., hydrophily (such as high-density polyethylene (HDPE), poly- aryl oxide, polyvinylpyrrolidone, gathers polytetrafluoroethylene (PTFE) (PTFE) polymer Vinyl alcohol, hydroxy alkyl cellulose, alginic acid, saccharide compound, caprolactone etc.) and above-mentioned mixture and combination.Hydrophily Polymer can be mixed between each other, or with by formula formulate amount water-insoluble compound (including some polymer) Mixing, to generate the coating with suitable lubricity, adhesiveness and solubility.

It should be understood that the disclosure is merely illustrative in many aspects.Without departing from the scope of the present invention the case where Under, it can be changed to details, particularly in terms of the arrangement of shape, size and step.Certainly, the scope of the present invention is It is defined with the sentence that appended claims are expressed.

It, can be without departing substantially from the scope of the present invention the case where although embodiments of the present invention have been shown and described Under make various modifications.Therefore, other than the following claims and their equivalents, the present invention be should not be so limited.This hair Bright embodiment is it is contemplated that have effectiveness, the various blood vessels include but is not limited in various blood vessels: coronary artery, neck are dynamic Arteries and veins, entocranial artery/arteriae cerebri, inferior caval vein and superior vena cava and other veins are (for example, in deep vein thrombosis or pulmonary embolism In situation), peripheral arterial, blood vessel short (shunts), vessel bridges (grafts), vascular defect portion and the chambers of the heart.This includes But it is not limited to any vascular with about 2mm or bigger diameter.It is expected that will have about seven French or smaller The suction lead 118 of overall diameter is used for many applications, but in some applications, it can be bigger.In some embodiments, It is expected that the suction lead 118 with about six French or smaller diameter.Embodiments of the present invention can even quilt In the application of non-vascular, for example, body cavity or with the cavity in material accumulation portion for needing to be macerated and/or removed.

It is contemplated that can special characteristic to embodiment disclosed above and aspect carry out different combination or son Combination, the combination or sub-portfolio are still fallen in one or more of present invention.In addition, appointing herein for an embodiment What special characteristic, aspect, method, performance, characteristic, quality, attribute, element etc. can be used to described in this paper all other In embodiment.It is, therefore, to be understood that the various features and aspect of disclosed embodiment can be combined with each other or generation It replaces, to form the different mode of disclosed invention.Accordingly, it is intended to be limited scope of the invention herein disclosed should not In specifically disclosed embodiment described above.Although in addition, particular instance of the invention have been shown in the accompanying drawings and It describes in detail herein, but different modification and alternative form can be made to the present invention.However, it should be understood that this Invention should not limited to particular forms disclosed or method, on the contrary, the present invention should cover all modifications, equivalent, with And alternative embodiments, these modification, equivalent and alternative embodiments all fall within described different embodiments In the range of the attached claims.Any method disclosed herein need not be executed by cited order.Institute is public herein The method opened includes the certain movements carried out by practitioner；But they can also be clearly or by implicit including those movements Any third party instruction.

Range disclosed herein further includes any and all overlappings, subrange and combinations thereof.Such as " up to ", " at least ", " being greater than ", " being less than ", " between " etc. language include cited number.It is used herein titled with such as " substantially ", " about " The number of the terms such as " substantially " includes cited number (for example, about 10%=10%), and is also represented by close to institute The amount for still executing required function or realizing required result for the amount of stating.For example, term " substantially ", " about " and " substantially " can refer to Amount in be less than the amount 10%, 5%, 1%, 0.1% and 0.01%.

Claims

1. a kind of system for sucking thrombus and transmitting medicament, comprising:

Suction lead has supply chamber and suction chamber, and the supply chamber has proximal end, distal end and wall, and the suction chamber has close End, open distal end and the inner wall surface adjacent with the open distal end；And

At least one aperture, it is described positioned at the supply far-end of chamber or adjacent with the supply distal end of chamber At least one aperture is fluidly connected to the suction chamber, at least one described aperture is positioned adjacent to the described of the suction chamber Open distal end, wherein at least one described aperture is configured to the generation when pressurized fluid is pumped through the supply chamber Spray pattern, so that the spray pattern is impacted in the suction chamber when the distal end of the suction lead is immersed in aqueous environment The inner wall surface on, and the spray pattern is made to be transformed into when in the inner wall surface in impact and can leave institute State the stream of the open distal end of suction chamber at least substantially distad oriented.

2. system according to claim 1, wherein the stream distad oriented includes jet stream.

3. system according to claim 1, wherein the spray pattern includes jet stream.

4. system according to claim 1, wherein the spray pattern includes at least two jet streams.

5. system according to claim 4, wherein at least one described aperture includes the first aperture and the second aperture, institute State that the first aperture is configured to generate the first jet stream at least two jet stream and second aperture is configured to produce The second jet stream in raw at least two jet stream, so that at least one of first jet stream and second jet stream are rushing It hits and is transformed into the stream substantially distad oriented when in the inner wall surface.

6. system according to claim 1, wherein the inner wall surface of the suction chamber includes deflecting element, described Deflecting element is configured at least partly generate the stream substantially distad oriented.

7. system according to claim 6, wherein the deflecting element includes inclined-plane.

8. system according to claim 7, wherein the inclined-plane includes the radius of the inner wall surface relative to the suction Enter the variation of the longitudinal axis of chamber.

9. system according to claim 6, wherein the deflecting element be configured at least partly generate substantially to The component of nearside orientation.

10. system according to claim 6, wherein the deflecting element is constructed such that the essentially all of spray It penetrates pattern and is transformed into the component substantially distad oriented when in the inner wall surface in impact.

11. system according to claim 1, wherein at least one described aperture is configured to relative to the suction chamber Longitudinal axis obliquely guide the spray pattern.

12. system according to claim 11, wherein at least one described aperture is constructed such that the spray pattern phase The longitudinal axis of the suction chamber is at least partly distad at an angle of.

13. system according to claim 12, wherein the inner wall surface of the suction chamber includes deflecting element, institute Deflecting element is stated to be configured at least partly generate the stream substantially distad oriented.

14. system according to claim 11, wherein at least one described aperture is constructed such that the spray pattern phase It is at least partly angled to nearside for the longitudinal axis of the suction chamber.

15. system according to claim 14, wherein the inner wall surface of the suction chamber includes deflecting element, institute Deflecting element is stated to be configured at least partly generate the stream substantially distad oriented.

16. system according to claim 1, wherein the supply chamber is configured in conveying lytic agent or contrast agent At least one.

17. a kind of method for transmitting medicament, comprising:

The suction lead having proximally and distally is provided, and the suction lead includes:

Chamber is supplied, there is proximal end, distal end and wall；

Suction chamber has proximal end, open distal end and the inner wall surface adjacent with the open distal end；And

At least one aperture, it is described positioned at the supply far-end of chamber or adjacent with the supply distal end of chamber At least one aperture is fluidly connected to the suction chamber, at least one described aperture is positioned adjacent to the described of the suction chamber Open distal end, wherein at least one described aperture is configured to the generation when pressurized fluid is pumped through the supply chamber Spray pattern；

The distal end of the suction lead is inserted into blood vessel, so that the open distal end of the suction chamber and thrombus phase It is adjacent；And

By the supply chamber injection medicament, so that generally outflow is described extremely in a first direction for the spray pattern of the medicament A few aperture and the inner wall surface against the suction chamber, so that the spray pattern in the medicament reaches the sucking After the inner wall surface of chamber, most of spray pattern of the medicament distally out suction chamber in a second direction Open end and adjacent with the thrombus, wherein the second direction is different from the first direction.

18. according to the method for claim 17, wherein the injecting step includes avoiding, reducing or eliminating in the sucking Apply negative pressure on chamber.

19. one kind is for making thrombectomby surgical procedure visualization method, comprising:

The suction lead with supply chamber and suction chamber is provided, the supply chamber has distal end and wall, and the suction chamber has spacious The distal end opened and inner wall surface, and the suction lead has aperture, the distal end phase in the aperture and the supply chamber Neighbour, the aperture are connected to the internal flow of the suction chamber, and the aperture is positioned adjacent to the described spacious of the suction chamber The distal end opened；

The distal end of the suction lead is inserted into blood vessel, so that the open distal end of the suction chamber and thrombus phase It is adjacent；

Include the fluid of radiopaque contrast agent by the supply chamber injection, while making radiographic X or fluoroscopy Image viewing；And

Identify the boundary of the thrombus.

20. according to the method for claim 19, wherein the injecting step includes hand injection.

21. according to the method for claim 20, wherein the hand injection utilizes syringe.

22. according to the method for claim 19, wherein the fluid includes lytic agent.

23. according to the method for claim 19, wherein the fluid includes contrast agent.

24. according to the method for claim 19, further includes:

Promote the suction lead.

25. a kind of system for sucking thrombus, comprising:

Suction lead has supply chamber and suction chamber, and the supply chamber has distal end and wall, and the suction chamber has open remote End and inner wall surface；

Aperture, adjacent with the supply distal end of chamber, the aperture is connected to the internal flow of the suction chamber, described Aperture is positioned adjacent to the open distal end of the suction chamber, wherein the aperture is configured to be pumped when pressurized fluid It send by generating spray pattern when the supply chamber；And

Mandrel has proximally and distally, and the distal end includes being greater than 90 ° of bending and including being configured to and the suction lead Distal engagement concave portion, wherein the aperture can be transverse to described by the tractive force being applied in the mandrel It is translated in the transverse direction of the longitudinal axis of suction lead.

26. a kind of system for sucking thrombus, comprising:

Aperture, adjacent with the supply distal end of chamber, the aperture is connected to the internal flow of the suction chamber, described Aperture is positioned adjacent to the open distal end of the suction chamber, wherein the aperture is configured to be pumped when pressurized fluid It send by generating spray pattern when the supply chamber, so that the spray when the distal end of the suction lead is immersed in aqueous environment Pattern impact is penetrated in the inner wall surface of the suction chamber；And

Fine filaments, have proximally and distally, this distally includes enlarged, wherein the fine filaments be configured to it is revolvable, The enlarged is enabled to destroy at least part of thrombus.

27. system according to claim 26, wherein at least part of the thrombus includes the fiber of the thrombus Cap.

28. a kind of system for removing encephalic blood or thrombus, comprising:

Probe has service duct and suction passage, and the suction passage has proximally and distally, and the service duct has remote End and wall, the suction passage have opening and inner wall surface, it is described opening be located at the suction passage the far-end or It is adjacent with the distal end of the suction passage；

Aperture, it is adjacent with the distal end of the service duct and be connected to the internal flow of the suction passage, wherein institute It states aperture to be configured to generate spray pattern when pressurized fluid is pumped through the service duct, so that the spray pattern Impact is in the inner wall surface of the suction passage；And

Vltrasonic device, the opening positioned at the suction passage or adjacent, and the Vltrasonic device quilt with the opening It is configured to about 1kHz to the frequency operation between about 20MHz.

29. a kind of method for removing encephalic blood or thrombus from patient, comprising:

The hole being passed through in the skull of patient places introducer；

Trochar is placed across the introducer；

Vltrasonic device is promoted to pass through described sleeve pipe needle to reach the treatment position in intracranial space；

Ultrasonic energy is transmitted from the Vltrasonic device with one or more frequencies between about 1kHz to about 20MHz；And

Blood or thrombus are removed from patient by probe and aperture, the probe has service duct and suction passage, the suction Entering channel has proximally and distally, and the service duct has distal end and wall, and the suction passage has opening and inner wall surface, It is described opening be located at the suction passage the far-end or adjacent with the distal end of the suction passage, the aperture with The distal end of the service duct is adjacent and internal flow with suction passage be connected to, wherein the aperture is configured to Spray pattern is generated when pressurized fluid is pumped through the service duct, so that spray pattern impact is in the sucking In the inner wall surface in channel, wherein remove blood or thrombus by the suction passage.